Do you check for contacts?

Specialties Emergency

Published

This is a silly question that just popped into my head yesterday. I wear those daily contacts. They have to be taken out everyday and thrown away or they could cause infection. Say I was to get in a car accident and I was unconscious. In the ER do you check for contacts, and take them out? I know that you look in the eyes with the light, looking for pupil dialation.

Forgive me. I know it is a silly question.

Specializes in Emergency & Trauma/Adult ICU.

Not routinely, unless the pt. is going to the OR.

Specializes in ICU.

I think I would notice contacts in patients admitted to the ICU. They are noticeable when looking at pupils/eyes. Would I take them out? I don't think so. I have received no training in removing contacts from patients and I would be afraid I would scratch the eye. It also most likely would not be high on my list of priorties for an ICU admit. But, I definately would mention it to the doctor and make sure someone took them out eventually if the patient was unable to.

Specializes in Hospital Education Coordinator.

So glad you brought this up! I used to work for eye surgeons. One of our best money-makers was disposable lens that people left in too long then stuck to the cornea and we got to do an expensive, painful cornea transplant. I am being facetious of course. A lot of those surgeries were preventable. When we admit patients to the floor we ask about eye wear and remove them (not hard at all and there are little suction cups available if you don't want to touch them). I hope more nurses will be aware now of the dangers in missing these little buggers.

Usually, if a patient was brought to me in a bad car accident, unconscious, but "stable" - upon looking at the pupils for PERL, I would attempt to take out the contacts if I had the chance to. I wear contacts so this is not a big deal to me.

However, if it is a patient circling the drain - then different story.....I have bigger fish to fry trying to stabilize the patient and get them to the OR....

Specializes in Med/Surg, Ortho.

Ive had to go after a contact that got left in someone's eye during surgery and it slipped off the iris and up onto the top of the eye. One of the other girls had come and got me because she didnt know what to do to get it. Normally you can moisten a sterile swab with NS and gently guide the contact to a spot that it can be removed either by you or by the patient if they are alert enough. Just dont guide the contact either back over the iris or pull with the swab tip over the cornea/iris. Have the patient look to the opposite side you are going to be working toward.

I wear contacts and I don't think leaving them in for an extra day will do any harm. If you do attempt to remove them, if they don't move freely, use alot of saline eye drops to moisten them, until they move freely, or leave them alone. You used to be able to leave them in for extended periods, I think they shortened the wearing period to avoid eye infections and lawsuits, but a day is not a big deal.

I take them out if the pt is unconscious. I do not wear them, never have, but I was married to someone who did and sometimes had to help him remove wandering lenses. Because lenses come different ways now....some you can leave in, some you can't, and you would have no way of knowing how long this pair had been in for, I would not take any chances and would remove them.

A contact wearer known to a friend's dad reportedly was in a muffler shop and accidentally saw an arc struck. He thought nothing of it. When he got home that night, he removed his contacts and his corneas came out with them. (Now I heard this long ago so it might involve glass contacts, but just the same, I wouldn't remove a pt's contacts--I'd ask a doctor do it, and if he were wise, he might call for an opthamologist. Seems like an everyday thing could turn suddenly invasive if there's something like an abrasive particle you didn't see, and I've never been trained in removing contacts, and even if I had, it wouldn't have been another person's.)

A contact wearer known to a friend's dad reportedly was in a muffler shop and accidentally saw an arc struck. He thought nothing of it. When he got home that night, he removed his contacts and his corneas came out with them. (Now I heard this long ago so it might involve glass contacts, but just the same, I wouldn't remove a pt's contacts--I'd ask a doctor do it, and if he were wise, he might call for an opthamologist. Seems like an everyday thing could turn suddenly invasive if there's something like an abrasive particle you didn't see, and I've never been trained in removing contacts, and even if I had, it wouldn't have been another person's.)

Gross!!!

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