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Author: Saidinejad, Mohsen MD; Burns, Michele M. MD
Journal: Pediatric Emergency Care. 21 (1):23-26, January 2005
Abstract: Minimizing pain and discomfort in an important consideration in pediatric ocular decontamination. The pH of an irrigant solution plays a significant role in its tolerability, because a solution with a pH that is too low or too high may cause edema and discomfort to the conjunctiva. We reviewed several available ocular irrigation solutions with respect to their chemical composition, pH and cost efficiency.
Currently, the irrigation solution of first choice for most ocular decontaminations in the pediatric emergency department (ED) is 0.9% saline solution for normal saline (NS), which has a pH range between 4.5 and 6.0. Alternative ocular irrigant solutions available include Lactated Ringers solution (LR), which has a pH range between 6.2 and 7.5, buffered NS with pH adjusted to 7.4 with sodium bicarbonate, and Balanced Salt Solution Plus (BSS Plus), which has a pH of 7.4. Of these alternative solutions, all except BSS Plus are comparable in cost efficiency to NS. The use of more pH neutral solutions such as LR, NS with bicarbonate buffer, or BSS Plus may decrease ocular pain and irritation associated with copious irrigation, and may improve tolerance of ocular decontamination by a child.
(C) 2005 Lippincott Williams & Wilkins, Inc.
While beginning to wear contact lenses, I had an experience which the use of the Morgan Lens saved the day.
I was just finishing a sixteen-hour shift as manager and staff nurse of the ED when I was notified that they had received a bomb threat. Disaster situation were part of my duties, so I went into action. By 4:00 AM, I realized I still had my contacts in. So I got a container and soaked them in an eye solution from our eye tray. I arrived home with enough time to take a quick nap before returning to work for another sixteen-hour shift. When I put my contacts in, I felt like someone had placed a hot poker into my eyes. I took the contacts out, but my eyes continued to burn and were also fire engine red. I did report to work at 7:00 AM but my eyes continued to burn. I then decided the best thing I could do was to irrigate, so I placed a Morgan lens into both eyes and irrigated with 1000 cc of lactated Ringer's. Laying down during the irrigation process was relaxing and I felt no discomfort while my eyes were irrigated. After the process, the burning was relieved and I was able to complete my shift without further discomfort.Registered Nurse (South Carolina)
The Morgan Lens is used in 90% of hospital emergency departments in the USA and can be inserted in less than 20 seconds. There simply is no other "hands-free" method of eye irrigation. Nothing else frees medical personnel to treat other injuries or to transport the patient while irrigation is underway. Nothing is more effective at treating ocular chemical, thermal, and actinic burns or removing non-embedded foreign bodies, even when the patient's eyes are closed tightly. Its design makes it simple and straightforward to use so minimal training is required.