# What else could/should I have done or considered



## Old Tracker (Aug 6, 2016)

2030 dispatch notifies about a 3 1/2 year old boy who fell. His right eye struck something on the ground and the Dad could see that the object, possibly 1/16th of an inch or less, appeared to have penetrated the rt eyelid.

Parents brought child to the station and there was slight bleeding from the probably puncture in the eyelid, as well as a small amount of blood coming from the closed eye. Cleaned the blood off of the eye and managed to get the little bit that had seeped out from the closed eye cleaned up. The right eye was swollen to about the size of a walnut, and the eye was shut, the child was resting quietly in his mother's arms and was sleeping. Parents stated no loc.

All vital signs were in the normal range for a 3.5 yo, O2 was 99% on RA. An aircraft was available and we drove the 65 miles so the child and mother could be airlifted to a trauma center.

Enroute, about all I did was monitor the vitals and try to reassure the mother. Turned over pt and mother to aircrew and returned to station.

What else could I, a Basic, have done for this child? The idea of forcing the eye open was a non-starter, but I am wondering if I should have or if it would have done more harm than good. Thoughts were, the child was calm, the mother, holding the boy was nervous, if I open the eye and the eye is punctured, it is possible for the mother to lose it, and besides the cleaning and covering, there wouldn't have been much to do.

What did I miss, what else could/should I have done?


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## NomadicMedic (Aug 6, 2016)

Sounds just about perfect to me. Nice job.


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## Old Tracker (Aug 6, 2016)

Thank you for the reply.


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## Jim37F (Aug 6, 2016)

Yeah sounds like you did everything you could for this kid. Besides bandaging up impaled objects so they don't move/come out, my protocols for eye injuries say cover up the whole eye (though unlike National Registry standards where they say cover both eyes our county says we only need to cover the injured eye), vitals and transport.


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## Old Tracker (Aug 6, 2016)

The object penetrated the eyelid, but stayed in the ground. I probably should have covered both eyes, but really didn't want to startle him, if he woke up and couldn't see anything. he did semi wake up a time or two on the way to meet the plane, but since he could see momma, he settled right back down.

Thank you for the responses, I feel better, but I know I still have a whole bunch to experience and learn.


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## NomadicMedic (Aug 6, 2016)

You'll learn that often the best medicine is no medicine. Keeping mom and the kiddo calm was the best thing you could have done.


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## WolfmanHarris (Aug 6, 2016)

Even if the object had penetrated deep enough to risk serious damage, I can't think of anything else that I would have done with the tools you have at your disposal. I often find the most challenging calls are the one's where you find yourself running through differentials and finding that once you have your short list, there's nothing to do but monitor and transport.


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## Old Tracker (Aug 6, 2016)

I do lots of monitoring and transporting As basics we do IV's but,I haven't been signed off on for that and we also do 12 lead monitoring. 12-lead basically tells us we need an intercept from the next town north.

I appreciate the feedback from y'all.


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