Intraocular Foreign Body & Broken Instrument Tip

Question 1

• Wear eye protection and make sure the are __
approved

• During patient treatment, disinfecting operatory,
preparing instruments, handling sharps or chemicals • Chemicals in ultrasonics, caviwipes, etc. can splash. • Patients should always wear eye protection during
patient care too.

Answer 1

ANSI

Question 2

Determine Appropriate Treatment when emergency happens

Answer 2

• Pain Level
• Velocity
• Composition (liquid or chemical, organic-dirty wood, etc, inorganic- metalic-steel lead iron or nonmetalic stone, plastic glass

**IS IT SUPERFICIAL OR EMBEDDED!!

Question 3

TX OF SUPERFICIAL FOREIGN BODY

Answer 3

1. Instruct patient not to rub-can cause corneal abrasions

2. Position the patient upright

Question 4

TX OF SUPERFICIAL FOREIGN BODY

Answer 4

1. Instruct patient not to rub-can cause corneal abrasions
2. Position the patient upright
3. Clinician degloves, if needed, washes hands, and regloves
4. Gently pull down lower lid and have patient look up
5. If foreign body obvious-remove with cotton swab (moisten cotton tip with saline, direct object away from pupil)
6. Irrigate the eye with either saline or water
7. Use emergency eyewash station or eye cup
8. Irrigate from medial to lateral portion of eye
9. Use this method for any liquid or chemical
10. 5 minutes for non-irritants or mild irritants
11. 15-20 minutes for moderate to severe irritants and chemical

Question 5

TX OF EMBEDDED FOREIGN BODY

Answer 5

1. Do not attempt to remove
2. Should only be performed by eye specialist
3. Cover both eyes to limit eye movements
4. Seek immediate care

Question 6

PREVENTION OF BROKEN INSTRUMENT TIP

Answer 6

1. Maintain instrument integrity
2. Replace thin instruments
3. Use proper instruments for area being treated
4. Use instrument correctly
5. Use ultrasonic scaler on patients with heavy deposits

Question 7

Etiologies Broken Instrument Tip

Answer 7

1. Fairly common
2. Etiologies
   - Excessively thin due to sharpening
   - Excessive force during instrumentation
   - Tenacious deposits
   - Defective instrument (uncommon)

Question 8

SIGNS AND SYMPTOMS OF BROKEN INSTRUMENT TIP

Answer 8

• Tip missing from end of instrument

- Patient may state they feel something lodged between teeth

Question 9

TX OF BROKEN INSTRUMENT TIP

Answer 9

1. Terminate procedure
2. Try no to alarm patient**
3. Ask patient not to swallow or move head
4. Isolate area where you were last working with gauze or cotton rolls
5. Maintain cheek/lip retraction
6. Do not suction, rinse or use air**
7. Examine immediate are to locate tip
8. If tip not visible blot gingiva area dry and examine closely
9. Probe sulcus/or curret- Carful not to push tip further into sulcus
10. If the tip is located remove with curet
11. Can use perioretriver
    - autoclavable
    - magnetized instrument
12. If tip not located take radiograph to locate and then remove
13. Explain what has occured to patient and show tip
14. If tip found on radiograph but cannot be removed refer to oral surgeon
    —– can use the SLOB rule to find?
    SAME Lingual
    OPPOSITE BUCCAL
15. If the object can not be located we will assume the patient has swallowed the object
16. We will send them to get a bronchoscopy and or endoscopy to locate the object