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) Lagophthalmos
 * Ocular surface disorder
 * Conjunctival Oedema (Chemosis)

Eye care interventions
Sedated patient- eye lubricant (also may add moisture chamber with polyethene film) Awake patient- Artificial tears
 * Sterile technique
 * Saline soaked gauze (some ICU’s may use sterile water) to clean. This is also known as “eye toilet”.
 * Patient sedation level:

Resources

[http://www.aci.health.nsw.gov.au/__data/assets/pdf_file/0009/239733/eyecare_11112013.pdf Johnson,K. & Rolls, K. (2013) Eye Care for Critically Ill Adults. NSW Agency for Clinical Innovation Intensive Care Coordination and Monitoring Unit] (Poster)

[http://www.aci.health.nsw.gov.au/__data/assets/pdf_file/0007/239731/ACI14_Man_EYE_care_2-3.pdf 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

[http://xa.yimg.com/kq/groups/17437113/480756053/name/eye%20care%20-%20rosemberg%20-%20ccm%20-12-08.pdf 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.]