The 2013 National EMS Scope of Practice requires in its Skill Set that paramedics be trained in the use of the Morgan Lens.
It is our hope that you will not just be trained, but will actually use the lens when the need arises. Experts universally agree that the sooner eye irrigation is started, the better the prognosis. Using the Morgan Lens at the scene of the accident will allow you to accomplish this. In addition, when you use the Morgan Lens, your hands are free to treat other injuries the victim may have or to treat other patients. Finally, transporting the patient while irrigation is underway is simple with the Morgan Lens, something that may otherwise be impossible in a moving vehicle or aircraft.
Frequently Asked Questions
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Why is the Morgan Lens ideal for EMS operations?
- The patient may be transported while irrigation is underway–once inserted, the Morgan Lens works on its own
- No other method of eye irrigation is “hands-free”, meaning you are free to treat other injuries or patients
- The Morgan Lens may be used following essentially any ocular chemical burn or to remove non-embedded foreign bodies
- Insertion is quick and simple–in just 20 seconds irrigation can be underway and you can move to more life-threatening injuries
- Eliminates the mess when irrigating eyes in a moving vehicle. Irrigating fluid is easily controlled when used with MorTan’s Medi-Duct
- Both eyes may be simultaneously irrigated with two Morgan Lenses (using one Morgan Lens Delivery Set or two standard I.V. giving sets)
- Don’t just “patch and ship”–you can be treating the ocular injury while you are transporting the patient
- Since the eyes may be closed while irrigation is underway, you are not fighting blepharospasms or photophobia. Increased patient comfort means irrigation may be continued as long as necessary
- “One size fits all”–the Morgan Lens may be used on infants, young children, and adults
- In pediatric applications, children have often been reported to fall asleep once they are able to close their eyes
What materials are needed for irrigating with the Morgan Lens?
- One or two Morgan Lenses–one per eye
- Topical Ocular Anesthetic (if available; not required)
- One Morgan Lens Delivery Set (part number MT202) or a standard IV set (two IV sets required when irrigating both eyes)
- One Bag of Irrigating Solution (MorTan recommends lactated Ringer’s (Hartmann’s) Solution)
- One or two Medi-Ducts (part number MT63)–one per eye–or towels, blue pads, or another fluid collection device
Is a topical ocular anesthetic required when using the Morgan Lens?
No. An anesthetic may help with the insertion of the lens as it may calm the patient and temporarily relieve pain. However, if an anesthetic is not available, the Morgan Lens may be inserted using the normal procedure (shown on our Instructions for Use page). Once in place, the irrigation solution will quickly begin to dilute and remove the chemical or foreign bodies and cool and soothe the injury, helping to relieve both pain and anxiety.
When should the Morgan Lens be used?
The Morgan Lens provides continuous irrigation for the treatment of ocular chemical burns. It may also be used for the removal of non-embedded foreign bodies, eliminating the need to sweep the fornices and cul-de-sac with a cotton swab. Essentially any ocular exposure to an acid, base, solvent, hydrocarbon, detergent or cleaning agent, or other irritant (including particulates, such as cement dust), may be treated with the Morgan Lens. Thermal or actinic burns may also be treated effectively with the Morgan Lens.
It should be noted that the Morgan Lens is not similar to a contact lens. Unlike a contact lens (or a bandage contact lens), the Morgan Lens does not rest on the eye, but instead delivers a gentle, constant flow of fresh irrigating solution that creates a space between the lens and the cornea. This continuously pushes the lens away from the surface of the eye, bathing the injured tissue and protecting it from the sweeping action of the eyelids while washing out caustics or particulate matter. Even when the eyelids are squeezed shut tightly, the irrigating solution is delivered to injury, unlike other methods which require the eyelids be retracted for effective irrigation.
What are the contraindications for the Morgan Lens?
There are only a few situations where the use of the Morgan Lens is not recommended:
- Do not use when there is a protruding foreign body
- Do not use with penetrating eye injuries
- Do not use with suspected or actual rupture of the globe
- Do not use anesthetic agents if there is a known allergy
How do I get trained?
MorTan offers a variety of training materials either on this website or available for free by contacting us. These training materials include:
- The Morgan Lens Instructional Video
- The PowerPoint Presentation
- Instructions for Use and the Recommended Uses Chart
- Sample Protocols and Links to On-line EMS Protocols
- Pediatric Use of the Morgan Lens
- The Morgan Lens Training Tool (free to qualified trainers and agencies)
Please click on any of the links above to be taken to that section of our website. Also, please refer to our Frequently Asked Questions page for additional information.
Why does MorTan recommend using lactated Ringer's (Hartmann's solution)?
Experts agree that ANY safe irrigating solution may be used in an emergency since it is so critical that irrigation be started quickly. However, the ideal eye irrigation solution is one that is readily available, has a pH close to that of the eye (approximately 7.1), acts as a buffer, and is inexpensive. Most experts agree that lactated Ringer’s (Hartmann’s Solution) comes the closest to meeting all of these. Irrigation with essentially any solution, however, is better than no irrigation at all, so while lactated Ringer’s is recommended, Normal Saline, water, or any safe solution should be used without delay if necessary.
The pH of lactated Ringer’s is 6.0 to 7.5, much closer to that of the healthy eye than Normal Saline (pH 4.5 to 7.0), which may be the reason NS is sometimes reported to cause a stinging sensation and minor morphological changes to the surface of the eye. In addition, lactated Ringer’s has a buffering capacity (approximately 0.00069) so that it is able to neutralize either acidic or basic solutions more quickly than NS, which has essentially no buffering capacity. Other commercially-available eye irrigating solutions may be used if available. Again, prompt irrigation with any safe solution, however, is better than no irrigation at all.
Why is MorTan's Medi-Duct ideal for EMS use?
When used with the Morgan Lens, the Medi-Duct (part number MT63) provides a convenient method for the collection of the irrigating solution. Attached to the side of the face below the injured eye, the Medi-Duct collects and wicks the outflow into a basin or other collection device. It is especially useful when transporting the patient as there is no need to continually change saturated blue pads or towels, and both the patient and the inside of your ambulance will remain drier. Please refer to our Accessories page for more information.
How can MorTan's Delivery Set help me?
The Morgan Lens Delivery Set (part number MT202) allows bilateral ocular irrigation without the need for two separate IV set-ups. One Delivery Set, attached to two Morgan Lens and a single bag of irrigating solution, can simultaneously irrigate both eyes. Since the pain in one eye may mask the pain in the other, irrigating both may be justified unless you are certain that the injury is confined to one eye, and the process is made much easier with the Morgan Lens Delivery Set. More details may be found on our Accessories page.
Why should I consider ocular irrigation following a motor vehicle accident?
Automobile airbags contain a solid propellant that allows the bag to explosively deploy in 50 milliseconds. The material, sodium azide, is ignited, creating gases that expand the bag. Sodium hydroxide and metallic oxides in particulate form are byproducts and may escape through the woven nylon airbag. If the airbag is torn, even greater quantities of the powders may be released. This has resulted in ocular alkali burns, thermal burns (sodium hydroxide generates heat when in contact with water), and irritation of the eye due to the fine particulates.
These ocular injuries may easily be overlooked, especially when there are life-threatening injuries or if the patient is unconscious or intubated, making a visual acuity test difficult if not impossible. If any evidence of ocular injury is noted following a MVA, immediate bilateral irrigation should be started and continued while the patient is transported. This process may be performed effectively and efficiently with the use of the Morgan Lens.