Let’s use this week as a cool down from all the talk of controlled substances over the last couple emails. This will be more of an FYI email, a reminder of what EMS does in the field. Attached are (BLS) Protocol 427 – Eye Injuries and (ALS) Protocol 527 – Chemical Eye Injuries.
427 lays out the initial BLS approach to a patient with an eye injury – they’ll be monitoring ABC’s, assessing for concomitant injuries, provide loose bandaging (WITHOUT putting pressure on the globe) and assisting with contact lens removal, if applicable. If there is concern for a foreign object, they will start irrigation with NS, and if there is an avulsion, they will stabilize, dress, and NOT attempt replacement (presumably after screaming internally, as we all would).
I include the BLS protocol because the ALS protocol starts by referring to BLS procedures (remember 1. that trauma is a BLS call type and 2. that good ALS care starts with good BLS care). The only thing 527 adds is topical analgesia in the form of either Proparacaine or Tetracaine. Did you know that ALS carries eye drops? Crazy!
All of this is Standing Order, so you likely won’t be receiving many OLMC calls with regards to these protocols, but hopefully this helps further your awareness of what sort of care patients may have received in the field.
Reach out with any questions/comments, check out www.nycremsco.org, and don’t forget about the binder!