Paramedic Guidelines for Eye Management - Essay Example

"Paramedic Guidelines for Eye Management" is an outstanding example of a paper on ophthalmology.
Emergency treatment and management guidelines provide a framework and a point of reference for the emergency team personnel (Woollard 2007, pp.893–894). The purpose of the establishment of a guideline is to provide acceptable standards for the management of patients who fall ill or are injured in emergencies of acute settings. Efforts must be made therefore to ensure that the guidelines are current and medically sound to be able to deliver to the current medical concerns and medical availabilities of the current patients (Dudley 2008, pp. 63-71). With regard to guidelines for management in emergency setups, this paper is purposed to provide a guideline for the management of an eye injury in an emergency.

General rules in paramedic emergency

• Personal protective equipment should be appropriately utilized
• Body substance isolation technique and equipment should be appropriately utilized
• A primary survey should be done on the patient to ascertain the potential diagnosis
• The secondary survey did like checking for artificial eyes or contact lenses
• Initiate transportation
  • The time at the scene of emergency should be minimized
  • Other life-threatening conditions should be managed en route
• The patient should be transported to the nearest appropriate health care facility
• All findings including the scene activities should be reported to the receiving staff to facilitate further management of the patient

Paramedic management of eye injuries

• In case the injury results in unconsciousness, the eyelids should be closed if the closing of the eyelid is not contraindicated by the injury (Drolsum 2009, pp.53–56).

Foreign objects

• When there is dislodgement of a foreign object in the eye, the patient should be reassures
• Locate the foreign object visually and do not touch the eye before locating the object
• If the foreign object is mobile and readily identifiable, attempt removal of the object using a clean nonsharp object
  • Roll up the eyelid if necessary for proper visualization of the object
  • Avoid pressing the object on the eye
• Removal of the foreign object should not be attempted if it is embedded on the eyelid or glob thus the patient should be transferred to a health care facility
• If the foreign object cannot be removed or embedded on the lid or globe, advice the patient to limit the movements of the eye

Injury to the lid and orbit

In case of an open wound injury to either the orbit or the lid;

• Neurological status and distal circulation must be assessed before dressing the patient
• The patient should not be allowed to exert self like through walking or standing unassisted
• The wound site should be exposed to determine the extent of the wound
• Clear the wound of loose foreign materials
• Control bleeding
• In case of injury to the lid, protect the underlying structures by ensuring the bleed does not drain to the eye (Waicus & Smith 2012, pp.24–29)

Impaled objects on the eye

In an event, there is an impaled object in the eye;

• The first step would be to stabilize the object by advising the patient to avoid moving the eye frequently
• Do not attempt to remove the object and transfer the patient to a nearby health facility for ophthalmological review
• Secure the object using a cone or cup and apply a bulky sterile dressing to stabilize the object
• The patient should be immobilized when necessary

Avulsion of the eye

In an event of an avulsion of the eye (Roka et al. 2012, pp.677–679);

• An attempt should not be made to put the eye back in the socket
• The avulsed eye should be covered with moist, sterile saline socked dressing
• The eye should be secured using a cone or cup over the avulsed eye and a bulk sterile dressing used to stabilize and prevent eye movement
• The patient should be transferred to the nearest health facility early enough for ophthalmological review 

Conclusion

Generally, an injured eye should not be covered with a dressing or bandage at the point of injury (McGwin et al. 2005, pp.970–976). Nevertheless, if the movement of the uninjured eye results in pain in the injured eye due to collateral movement, then the injured eye should be covered. However, when the injured eye is covered, the patient must be closely monitored and emotional support provided since the loss of vision even a short-term one results in emotional trauma (Kelly 2007, pp.746–747).