2-3

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2-3. PRINCIPLES OF APPLYING A DRESSING

a. Reassure the patient. From your own experience and personal insight, you know that eye injuries are very frightening. Explain to the patient what you are going to do.

NOTE: Remember that the eye is a sensitive structure and the patient will have a

natural tendency to protectively withdraw.

b. Explain to the patient not to squeeze his eyelids together.

NOTE: Squeezing the eyelids together could cause further damage to the eyeball

(globes).

c. Position the patient. Positioning the patient helps to control pain and bleeding.

(1) Conscious patient--place him in a sitting position.

 

(2) Unconscious patient--place him in a supine position. This will help to prevent pressure from building in the eye.

d. Take precautions to protect the eyeball. Do not touch or remove any penetrating foreign body protruding from the eyeball.

(1) This will help to prevent the vitreous humor (jelly-like fluid) from leaking out. The vitreous humor fills the space behind the lens. It also maintains the shape of the eyeball. Loss of vitreous humor will cause the eyeball to collapse.

 

(2) Protruding objects are only removed by surgery.

e. DO NOT push an extruded eyeball back into the socket. It can cause contamination, mechanical damage, and/or further eyesight loss.

f. Avoid exerting pressure on the patient's eye. pressure or pressure dressing may cause additional eyeball damage, forcing out the vitreous humor and/or eyeball to lose its shape.

NOTE: A pressure dressing is applied only by a physician's order.

g. Never force open a patient's eyelids when there is severe eye injuries or indications of severe eye injuries.

NOTE: The patient may experience little or no pain or the injury may seem to be minor.

The patient may complain of severe pain or will probably squeeze his eyelids

tightly shut.

NOTE: Remember that force can cause further damage. It is possible that a foreign

body may be in the eye and the object may be attached to the inside of the

eyelid.

h. Close eyelids prior to dressing. This will protect the eye from possible scratching of the cornea by a gauze pad.

(1) Conscious patient--tell him to gently close his eyelids.

 

(2) Unconscious patient--you must gently close his eyelids.

NOTE: Closing the eyelids helps to prevent drying. Drying can cause more damage.

Also, damage can be caused by strong light, whether the patient is conscious

or unconscious. Strong light could come from the sun, welding equipment,

snow, or ice.

i. Cover severely injured eyes (eyeball) with loose dressing.

(1) Cover both eyes even if only one eye is injured. Remember that when one eye moves, the other eye duplicates this movement (this is referred to as sympathetic movement). Covering the eyes will also reduce further damage.

 

(2) The patient should be evacuated with both eyes covered.

j. Cover injury to soft surrounding eye tissues, (black eyes, cut on eyebrow, or eyelids). Cover only one eye. This will allow the patient to walk around without being assisted by others.

NOTE: In hazardous surroundings, it may be necessary to leave the uninjured eye

uncovered, regardless of severity of the injury to the uninjured eye.

k. Dressing techniques.

(1) Use only sterile dressing.

 

(2) Avoid covering a patient's nose, mouth, and ears.

 

(3) Prevent dressing from slipping down to the patient's neck.

l. Prepare Patient for Evacuation.

NOTE: Allow for patient to be evacuated quietly and in a supine position if he is unable to walk or is unconscious.

Continue with Exercises

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