Young children fear having anything placed in their eyes, and special care is often needed to reduce the child’s anxiety and promote cooperation during instillation of ophthalmic medications. An explanation of the procedure may help gain the child’s cooperation. To prevent the transfer of pathogens to the eye, the medication and its dispensing port must be kept sterile.
• Irrigation of the eye is performed to flush out a foreign body or a chemical irritant.
– Children often close the injured eye tightly, so getting them to relax for this procedure is important. Care must be taken not to touch the cornea, which could cause further eye injury. Careful aseptic technique is needed to prevent infection.
1- Check the physician’s orders for the type of fluid and the volume to be used (most often sterile normal saline).
2- The child will need to be held in position for this procedure. An assistant can hold the child supine with the body over the child’s, keeping the child’s head turned slightly so that the eye to be irrigated is lower than the outer eye.
RATIONALE: This method is used to avoid cross-contamination of the eye not being irrigated.
3- Attach the IV tubing to the bag of room temperature normal saline. Purge the line, but keep the tip covered.
Equipment and supplies:
• Absorbent pads
• Irrigation solution and tubing pads.
Procedure: Sterile Gloves
1- Place absorbent pads under the child’s head, neck, and shoulders, using towels for extra absorption. Place an emesis basin under the lower eye to catch drainage.
2- Don gloves.
3- Using the thumb and forefinger of the dominant hand, gently separate the child’s lids.
4- Remove the cover from the IV tubing. Open the clamp midway, pointing the stream of fluid into the lower conjunctiva sac from the inner to the outer canthus. Periodically turn off the stream of solution and have the child close the eye.
RATIONALE: This procedure allows the solution to also move into the upper conjunctival area.
5- When the irrigation has been completed, dry the child’s eye gently with gauze or a cotton ball from the inner to the outer canthus.
6-Assess the return for color, odor, and character.
•Gauze pad or cotton ball
PROCEDURE: Clean Gloves
1- Have another nurse, an assistant, or the parent restrain the child while the injection is being given.
2- Don gloves.
3- Locate the site. Clean with alcohol using an outward circular motion.
4- Pinch the skin between the thumb and index finger.
5- Remove the cap from the syringe. Insert the needle quickly at about a 45-degree angle. Release the skin and pull back the plunger.