# Broken glass in eyes?



## Gents82

Hey guys. New to the forum here. 

Just had a quick question. It ran cross my mind that this was never touched during class and I'm almost certain it happens out there. Broken glass in the eyes. From lets say a shattered windshield or a broken beer bottle during a fight. How would this be treated? Do you brush it away? Flush it down with water? Bandage the eyes and tell them not to blink? Any advice would be appreciated.


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## Jon

usually it dosen't get "in the eyes" but arount the eyes and the face.

Most folks tend to blink and keep it out.

Also, many times, when someone says "I've got glass in my eye" - it isn't still in, but the pt. has a cornael abrasion, etc., from something that WAS in the eye for a second before it was blinked out.

Either way.... irrigate - Dual-eye irrigation is easy with a Nasal Cannula to a 1000 bag of NSS and macrodrip tubing.


I do first aid at scout events... we had a group of young scouts decide to throw a wet peice of slate into the fire a year ago.  (That was a mess) - 3 scouts transported... 3 with pain in eye(s) 1 of 3 with back/neck pain, and 1 of 3 screaming in pain because he couldn't see....

Fun time.


So.. irrigate, if an actual object is visible, don't touch it, cover the eye and object with a cup if impaled object.


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## Wingnut

First    Welcome!!   

Second, we never went over it either, but I would imagine that flushing or sweeping away the glass would be looked down upon. Scratching, impaling are easy to do, I would _guess_ we'd bandage the eyes as best we could and get them to the ER.

Great question, I hope someone knows the right answer!


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## MedicPrincess

It would be completely impossible to cover every single possible injury we might encounter while working in the field.  Glass in the eye was not specifically addressed for user.

Now I would say glass "in the eye" would be treated as what it is, a foriegn body.  If the patient gets dust, chemicals (in some instances), or other items you you irrigate the eye.  Glass should be treated the same way.  If I remember correctly, itsn't it like for 20 minutes or until you reach the hospital.

Copious amounts of water until the item is out, and then flush some more.  If you see glass around the eye, but not in it, you could brush it way.

NOW, if we are talking about a large piece of glass actually penetrating the eye, obviously that is different.


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## Gents82

Yeah I didn't mean a huge penetrating piece, I was thinking more along the lines of sandlike. I figured flushing it with water would be the best way, but I wasn't certain. I know glass can scratch the eye...seems tricky. So are we all on agreeance then? Flush with water, brush away any other pieces on the face, and bandage to avoid infection?


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## i_drive_code3

*ewww eyeballs...*

:wacko: LOL...eyeballs and fingernails are my gross-outs but i digress!

small particles - i would irrigate at least 20 minutes, i agree that it is less likely to be actual particles but more likely scratched corneas from the particles that will cause irritation

if we don't want someone to blink we would want to cover both eyes and even then have you tried to NOT blink especially if you feel something in your eye?

and i agree with everyone else about dealing with impaled objects

ya know this is one thing i LOVE about my job - there are almost as many "plans" out there as there are responders on a call... i mean we all have basic "rules" to follow but then sometimes the actual implementation of those rules is pretty varied...

anyhoo 
take it easy!

kate


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## JJR512

I've seen a lot of guessed answers to this particular question.

Now forgive me for stepping in here, because I'm new here and still in EMT-B class. But it's my impression that if something isn't covered or you're not sure what to do, the correct thing to do is _not_ to "guess" at the correct treatment. Rather, isn't the correct answer to this question to "seek medical direction"?


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## Wingnut

Yes JJ, you're right, but seeing as how our "patient" is hypothetical, it's ok to guess.


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## MedicPrincess

JJ, the other thing you will learn is there is more than one way to do something.  While I may say flush they eye, someone else may see the situation different and think we need to cover it and wrap it.  In that casy you would need to cover the other eye as well, to prevent either eye from moving around.

You cannot seek medical direction on every single call, eventually common sense has to prevail.  Now, I understand they cannot teach common sense, but everyone has to strive for it.


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## Stevo

the 'ol nasal canula on a bag trick comes to mind....

~S~


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## JJR512

Well, I didn't mean that every call needs to involve the doc-in-a-box. It's a perfect textbook answer, though: "If you don't know or aren't sure, consult medical direction." I imagine that out in the field, when I'm still "new", for however long that is, it will be my instinct to fall back on that standard, unless I was with someone who _did_ know. But my volunteer fire station is BLS-only (the station's first-due area is surrounded by ALS-equipped stations), so I may not frequently be with someone who knows a whole lot more than me (in terms of book knowledge; experience is, of course, another matter). Down the road, as I gain more experience, I'm sure I'll learn a lot of things that aren't covered in training or in the protocols. But that brings up a very important consideration: As an EMT-B, if one way or another I learn things that aren't in the official training or protocols, couldn't I get in a lot of trouble for practicing said street knowledge if I didn't get medical direction's orders to do so? That's what they taught me in class, anyway. "Go by the book or consult medical direction." So, we may or may not know what to do in this admittedly hypothetical situation, but in real life, unless it's in your own local protocols, you'd be calling the doc-in-a-box, right?

Oh, and I'll be the first to admit I can sometimes be a bit short in the common-sense department...but I more than make up for that with uncommon sense.


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## TTLWHKR

Irrigate until it stops hurting or burning, then cover it up. Cover both eyes...

If it won't come out w/ irrigation... Cover it up.


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## TTLWHKR

Protocols cover specific procedures, etc.

I've never seen a set of protocols that cover elementary first aid. Some things you just have to learn by reading, watching and doing. Which is why I'm a big supporter of EMT's doing clinicals, which is not required in PA. 

Often you will only see "treat as needed" or something to that effect. This is where it helps to be inventive.


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## F.D.N.Y.E.M.T

Gents82 said:
			
		

> Hey guys. New to the forum here.
> 
> Just had a quick question. It ran cross my mind that this was never touched during class and I'm almost certain it happens out there. Broken glass in the eyes. From lets say a shattered windshield or a broken beer bottle during a fight. How would this be treated? Do you brush it away? Flush it down with water? Bandage the eyes and tell them not to blink? Any advice would be appreciated.


Hey buddy whats sup  
Well to answer ur question about the eye INJ real quick, 
I would just stablize the wound (eye) and I defintly wouldn't dust it off, or try to take the glass out, cause you could spread and move the glass around in the eye thus causing more injury. and u have to keep in mind that the patient isn't going to be staying still at all. so ur best bet would be to treat it like a puncture wound; and not remove it and cover the eye, make sure you cover the other eye also cause if u don't the injured eye would move cause it will follow the movement of the unaffected eye. So long story short cover both eyes and load and go to the nearest trama center ok brother  

(and if its a car accident make sure that u dont have life threating injuries if so tend to those 1st, )


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## ffemt8978

FDNY, welcome to our own little corner of dysfunction.

As far as this scenario goes, I would probably irrigate the eye the entire way to the hospital (45-60 minutes) using the NS via NC method.  I would also place some 4x4's over the eyes just to keep them from looking around, but my primary focus would be the irrigation.


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## i_drive_code3

*no clinicals???*



			
				TTLWHKR said:
			
		

> Protocols cover specific procedures, etc.
> 
> I've never seen a set of protocols that cover elementary first aid. Some things you just have to learn by reading, watching and doing. Which is why I'm a big supporter of EMT's doing clinicals, which is not required in PA.
> 
> Often you will only see "treat as needed" or something to that effect. This is where it helps to be inventive.



man, remind me not need bls treatment in YOUR neck of the woods!! :unsure: in this area we only had to do 10 hours: 5 with an als provider and 5 in the er and i thought that was seriously lacking....

kate


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## TTLWHKR

It's not my fault... Blame the state, which I can name a dozen or more with the same training.

Doesn't phase me though. I'm a Paramedic, my service only does ALS, and doesn't employ any BLS providers. It's a dog eat dog world, the rest are on their own.


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## Jon

Stevo said:
			
		

> the 'ol nasal canula on a bag trick comes to mind....
> 
> ~S~


Yeah.... I think I covered that.




FDNY - Welcome to EMTlife - we put the *Fun* in Dys*fun*ctional.


Jon


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## emtff376

FDNY - Welcome!


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## Gents82

ffemt8978 said:
			
		

> FDNY, welcome to our own little corner of dysfunction.
> 
> As far as this scenario goes, I would probably irrigate the eye the entire way to the hospital (45-60 minutes) using the NS via NC method.  I would also place some 4x4's over the eyes just to keep them from looking around, but my primary focus would be the irrigation.



I'm a little lost. What is the NS via NC method?


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## ffemt8978

Normal saline IV bag connected to a Nasal Cannula set.  Then you place the prongs of the Nasal Cannula over the bridge of the nose to irrigate both eyes at the same time.


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## TTLWHKR

Or you can connect the NasCan to a squirt cap for a bottle of irrigation solution. Some bottles have a hook on the bottom, such as those produced by Aqualite. Others, just use heavy tape and hook it to either the IV hanger or a ceiling bar.


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## JJR512

-disregard, sorry-


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## Ridryder911

I would defnitely NOT irrigate the eye, this would cause more movement of the glass causing corneal abrasions and laccerations. I would remove large pieces from the outside area and lightly cover both eyes. 

These patients need to have fluorscoped performed and slit lamp to determine if globe laccerations are involved. 

Flooding the eye only causes the eye to blink, and move thus potentially causing more damage. 

After inital exam chances are they will refer to opthmalogist for more in-depth exam... 

Be safe,
R/R 911


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