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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.
An ambulance was dispatched to a local industry for a worker who had been sprayed in both eyes with brake fluid under pressure. On scene, our paramedic inserted bilateral Morgan Lenses. He proceeded to flush both eyes simultaneously with approximately 1500 cc N.S.S. on the way to the hospital. The patient tolerated the entire procedure very well, felt much better, and an examination of the patient's eyes, after the Morgan Lens removal, showed no tissue damage. The patient had a full recovery with no complications, thanks to the availability and efficiency of the Morgan Lens system.Registered Nurse (New Hampshire)
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.