Chemical Eye Injury
Objective: Start irrigation on scene for chemical splash to the eye and keep it going — alkali is worse than acid in the field.
Why This Is Hard
They want a dressing and a clinic. Alkali (drain cleaner, lime) keeps saponifying the cornea after you leave. Poison-center and ophthalmology teaching: immediate, copious irrigation beats a 10-minute visual acuity test.
- Flush with whatever clean water or saline you have. Moran's/Morgan lens if trained and authorized.
- Remove contacts if they come easily. Do not dig.
- Take the container if it is safe. Poison control.
Field Rules (Education)
- Alkali > acid for ongoing damage. Both get irrigated.
- Start now. Do not wait for a pH strip you do not carry.
- Keep going during transport if they tolerate it.
- No neutralizing chemicals from the garage (vinegar into alkali, etc.). Water/saline.
Field Pitfalls
- A dry patch and a delay.
- Neutralizing with another chemical.
- Skipping irrigation because they can still read a name tag.
Practice
60-second drill
Partner: drain cleaner splash, screaming, one eye. First 30 seconds including what you will not put in the eye.
Related: Poison center thinking.
Sources & Further Study
Named guidelines for further study. They are not clinical orders and do not replace your protocol or medical direction.
- NASEMSO National Model EMS Clinical Guidelines (2022) — U.S. EMS model language; protocol still wins
- America’s Poison Centers — immediate irrigation; do not neutralize with another chemical
- Ophthalmology/poison-center teaching: copious irrigation is the field intervention that changes outcome.
Education only. Apply learning within your protocols and medical direction. This is not clinical care guidance.
Check Your Understanding
Street decisions from this lesson only. After you check, the key is highlighted. Education practice — not a certification exam.