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CLEARED (Chemicals and Litmus testing with Effective Alkaline Range for Eye Damage): A Prospective, Interventional Study.
- Source :
-
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine [Acad Emerg Med] 2019 Jul; Vol. 26 (7), pp. 796-802. Date of Electronic Publication: 2018 Nov 02. - Publication Year :
- 2019
-
Abstract
- Objectives: While immediate diagnosis and irrigation is standard chemical eye burn practice, it is unknown to what extent specific pH measurements influence management, given the frequent clinical availability of narrow-spectrum nitrazine pH strips. We hypothesize that exclusive broad-spectrum pH strip implementation leads to more accurate measurement and expedited ophthalmologic consultation.<br />Methods: At a Level I trauma center over 25 months, all emergent adult ophthalmology consultations for chemical burns were included in a pre-intervention (n = 22) and post-intervention (n = 20) study design. During this time, narrow-spectrum nitrazine pH strips available to non-obstetric emergency department (ED) staff were exclusively replaced by broad-spectrum strips. Causative chemical, time from triage to ophthalmology consultation, examination findings, ocular pH by ED and ophthalmology staff, and irrigation quantity were analyzed.<br />Results: Most burns were alkaline. Time from triage (p = 0.043) and irrigation quantity following consultation (p = 0.047) each decreased following exclusive ED implementation of broad-spectrum pH strips. There was greater pH congruence between consulting and primary physicians after intervention (p = 0.03).<br />Conclusions: Exclusive non-obstetric implementation of broad-spectrum pH strips may allow greater accuracy and faster management of ocular chemical burns. Availability of narrow-spectrum pH strips may be dangerous clinically by falsely reassuring the examiner with inherent inaccuracy.<br /> (© 2018 by the Society for Academic Emergency Medicine.)
Details
- Language :
- English
- ISSN :
- 1553-2712
- Volume :
- 26
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 30246924
- Full Text :
- https://doi.org/10.1111/acem.13622