Tetracaine

Morgan Lens

I rank Tetracaine 30 on my list of 33 drugs.

We use Tetracaine prior to insertion of Morgan lenses in patients age 6 years and older who have sustained an exposure injury to the eye(s), (i.e. dry or liquid chemical).

The drops numb the eye and make it easier for the patient to tolerate the Morgan Lens.

Here is our Morgan Lens procedure:

Explain procedure to patient and give rationale.
Unless contraindicated*, instill one or two drops of Tetracaine.
Instruct patient not to touch/rub eye(s).
Spike IV bag and attach/flush tubing, connect Morgan Lens, maintain sterile environment of Morgan Lens.
Have the patient look down, insert the Morgan Lens under the upper lid, then have the patient look up, retract lower lid and allow lens to drop into place.
Begin flow rate at wide open and maintain this rate per patient tolerance. Have plenty of towels or chux to absorb flow.

Tetracaine is a nice little drug, but it has been years since I have used a Morgan Lens. When I worked more regularly in the city and dealt with more patients who had been maced or pepper-sprayed, I had more occasion to use the Morgan Lens, although many times we just irrigated the eyes with the IV tubing, as ift takes a high-level of cooperation for a patient to accept a Morgan Lens in their eye.

Nice to have Tetracaine in the kit, but I can do without it if I have to.

***

Tetracaine Ophthalmic Solution

Class: Topical anesthetic for the eye only

Action: Produces anesthesia in the eye approximately 30 seconds after application

Indication: For pain control in burns to the eye

Contraindication: Known allergic reaction to Tetracaine or Novocain type medications.

Dose: 1 or 2 drops to the affected eye

Route: Topically to the eye

Pedi dose: 1 or 2 drops to the affected eye

4 Comments

  • Wow, y’all have Morgan lenses?

    We’ve always had to make do with the “nasal cannula plugged to the IV tubing” technique.

  • John says:

    Are EMT’s allowed to give this drug and use a Morgan lens? I’m sure I know the answer but want to see what you all think.

  • Rhody Davies says:

    Sir, Thank you for these VERY helpful postings. I am a new, green Paramedic and the information in this series have answered several questions that I have been unable to find answers.

    Again thank you for helping to continue to educate those of us still interested in knowledge.

  • medicscribe says:

    The Morgan Lenses are for medic use only, but I think the nasal cannula idea Ambulance Driver mentions works almost as well for our purposes.

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Peter Canning

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