First aid for a chemical eye injury — OSCE

Communication and acute-care OSCE on a child who has had a household alkali splash to the eye, in which the candidate must explain and initiate immediate copious irrigation before any examination, reassure an anxious parent that the single most important treatment is irrigation and that delay is the enemy, outline the irrigation protocol and the next steps, and give a clear safety-net — covering the irrigation-first principle, removal of particulate matter, the pH endpoint, and urgent ophthalmology referral.

osce communication acute-care irrigation-first safety-net4 min readVerification in progress

Prompt

A 6-year-old is brought to the emergency department immediately after a dishwasher-tablet alkali powder burst into her right eye at home. The child is in severe pain, the eye is firmly shut and watering, and the parent rinsed it briefly under the tap before coming in. The parent is anxious and asks whether the eye will be okay, what you are going to do right now, and what to expect. The candidate must initiate and explain immediate copious irrigation before any examination, reassure the parent that irrigation is the treatment that matters, outline the protocol and next steps, and give a clear safety-net.

Candidate instructions (8-minute station)

You are the paediatric registrar in the emergency department. A 6-year-old has just arrived after a dishwasher-tablet alkali powder burst into her right eye. The child is in pain and the eye is shut and watering; the parent briefly rinsed it under the tap at home. The parent is very anxious. ^[5]

Your tasks are: ^[5]

State and initiate the correct immediate action — copious irrigation, before any examination — and explain to the parent why it must come first. ^[5]
Reassure the parent that the most important treatment is the irrigation they helped start and that delay is the main enemy. ^[5]
Outline the irrigation protocol (fluid, duration, removing particles from under the lids, checking the pH) and the next steps including urgent ophthalmology. ^[5]
Give a clear safety-net and household-chemical-safety advice for the future. ^[8]

You are not expected to perform a slit-lamp examination before irrigation, to grade the burn before the eye is flushed, or to manage a suspected open globe in this station — the priority is to demonstrate and explain irrigation-first. ^[8]

References3Show

[5]Wagoner MD Chemical injuries of the eye: current concepts in pathophysiology and therapy. Surv Ophthalmol, 1997.PMID 9104767
[4]Dua HS; King AJ; Joseph A A new classification of ocular surface burns. Br J Ophthalmol, 2001.PMID 11673310
[8]Salvin JH Systematic approach to pediatric ocular trauma. Curr Opin Ophthalmol, 2007.PMID 17700228

First aid for a chemical eye injury — OSCE

osce communication acute-care irrigation-first safety-net4 min readVerification in progress

Candidate instructions (8-minute station)

Your tasks are: ^[5]

State and initiate the correct immediate action — copious irrigation, before any examination — and explain to the parent why it must come first. ^[5]

Reassure the parent that the most important treatment is the irrigation they helped start and that delay is the main enemy. ^[5]

Outline the irrigation protocol (fluid, duration, removing particles from under the lids, checking the pH) and the next steps including urgent ophthalmology. ^[5]

Give a clear safety-net and household-chemical-safety advice for the future. ^[8]

References3Show

[5]Wagoner MD Chemical injuries of the eye: current concepts in pathophysiology and therapy. Surv Ophthalmol, 1997.PMID 9104767
[4]Dua HS; King AJ; Joseph A A new classification of ocular surface burns. Br J Ophthalmol, 2001.PMID 11673310
[8]Salvin JH Systematic approach to pediatric ocular trauma. Curr Opin Ophthalmol, 2007.PMID 17700228