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Ocular Irrigant Alternatives in Pediatric Emergency Medicine

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.

The Morgan Lens has proven to be an indispensable aid in my thirteen years of emergency practice.  During that time, my work has taken me to eight or ten different hospitals and medical centers, and I'm always happy to say each and every one of them has kept the Morgan Lens in stock and at the ready.  And, each time a patient is suddenly presented with a chemical or other toxic eye exposure, it is immediately apparent that there is simply no substitute for this product.  In these situations, I have come to depend on it.  I think this testimonial simply reflects what every other emergency physician knows about your landmark device.


...could not effectively irrigate his eyes with IV tubing...

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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.