Intensive Care Nursing/Essential Nursing Cares (eye,mouth)

Eye Care

The potential for damage to the eyes is a recognised risk for the ICU patient due to sedation and paralysing agents, reduced or absent blinking, infection and the environment. Rosenberg (2008) state that 20-42% of ICU patients develop exposure keratopathy.

To start, take a look at these resourcesː

|The Eye

How The Eye Works

Eye Assessment

Part of routine practice as part of initial thorough assessment at the start of each shift. Assess forː

Eye & eyelid general cleanliness
Signs of infection or red eyes (Viral or bacterial conjunctivitis)
Risk factors for Ocular Surface Disorder (OSD)
Keratopathy (corneal damage)
Corneal dryness, discolouration or ulceration
Lagopthalmus (incomplete eye closure) Wikipedia:Lagophthalmos
Ocular surface disorder
Conjunctival Oedema (Chemosis)

Eye care interventions

Sterile technique
Saline soaked gauze (some ICU’s may use sterile water) to clean. This is also known as “eye toilet”.
Patient sedation level:

    Sedated patient- eye lubricant (also may add moisture chamber with polyethene film)
    Awake patient- Artificial tears

Resources

Johnson,K. & Rolls, K. (2013) Eye Care for Critically Ill Adults. NSW Agency for Clinical Innovation Intensive Care Coordination and Monitoring Unit (Poster)

Johnson,K. & Rolls, K. (2013) Eye Care for Critically Ill Adults. NSW Agency for Clinical Innovation Intensive Care Coordination and Monitoring Unit (Guideline)

Kam et al (2013) Eye Care in the Critically Ill: A National Survey and Protocol

Rosenberg, J. B., & Eisen, L. A. (2008). Eye care in the intensive care unit: narrative review and meta-analysis. Critical care medicine, 36(12), 3151-3155.