A client arrives in the emergency unit and reports that a concentrated household cleaner was splashed in both eyes. Which of the following nursing actions is a priority?
A. Examine the client's visual acuity
B. Patch the eye
C. Use Restasis (Allergan) drops in the eye
D. Flush the eye repeatedly using sterile normal saline
Correct Answer: D. Flush the eye repeatedly using sterile normal saline.
Initial emergency action during a chemical splash to the eye includes immediate continuous irrigation of the affected eye with normal saline. Immediate irrigation with copious amounts of an isotonic solution as described previously is the mainstay of treatment for chemical burns. Never use any substance to neutralize chemical exposure as the exothermic reaction can lead to secondary thermal injuries.
Option A: After irrigation, visual acuity then is assessed. Irrigation should continue until the pH of the eye is between 7.0 to 7.4 and remains within this range for at least 30 minutes after the irrigation has been discontinued.
Option B: Patching the eye is not part of the first-line treatment of a chemical splash. Irrigation should be gentle, and care should be taken to avoid direct irrigation to the cornea to prevent further injury. Use of a commercial irrigation lens such as a Morgan lens may be helpful.
Option C: Restasis (Allergan) drops are used to treat dry eyes. A topical anesthetic such as tetracaine can be applied directly to the eye, or 10 mL of 1% lidocaine can be added to a liter of irrigating fluid, taking care not to reach a toxic dose if copious irrigation is required.
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