What is the first step in providing first aid to casualty with chemical burn in eye?

Appeared in: NVS- 2025

Explanation

The absolute priority in a chemical eye burn is to remove the causative agent as quickly as possible to stop ongoing tissue damage.
Immediate and copious irrigation with water or saline effectively dilutes and flushes the chemical from the eye's surface.
This action minimizes the duration of chemical contact with the cornea, directly reducing the severity of the injury and preventing or limiting permanent vision loss.
All other first aid measures are secondary to the immediate need for decontamination through flushing.

Option A: While hospitalization is necessary, it is not the first step. Delaying irrigation to transport the patient allows the chemical to cause irreversible damage.
Option B: Applying an ointment is contraindicated as a first step. It can trap the chemical against the cornea, intensifying the burn and making it more difficult to wash out.
Option D: Covering the eye without first removing the chemical will trap the irritant against the eye tissues, worsening the burn and preventing removal.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain First aid management for chemical eye injury as background academic context rather than a clinical decision trigger.
Chemical eye burns are true ocular emergencies where the nurse's prompt action can save a patient's sight. Initiating immediate irrigation is a critical nursing responsibility.
Nurses should be prepared to perform eye irrigation in any setting and educate bystanders on the importance of this immediate first aid measure.
What if? If the chemical is a dry powder (e.g., lime), the first step is to brush off as much powder as possible before starting irrigation. Adding water to some dry chemicals can create a more corrosive solution.

How to Approach the Question

First, identify the question type. This is a priority-setting question asking for the 'first step'.
Analyze the clinical situation: a chemical is actively burning the eye tissue. The core problem is the continued presence of the harmful agent.
Evaluate the options based on which action most directly and immediately resolves the core problem.
Option A (transport) delays treatment. Options B (ointment) and D (pad) make the problem worse by trapping the chemical.
Option C (rinse with water) is the only action that directly addresses the cause of the injury by removing the chemical.
Therefore, rinsing the eye is the highest priority and the correct first step.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 2 Part 1 pp. 108-110, 109-111

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1787-1789

Practise the full NVS- 2025

Attempt every question from this paper in a timed mock, then review the full solution for each one.