Journal Jam 6 – Outpatient Topical Anesthetics for Corneal Abrasions
Emergency Medicine Cases
Dr. Anton Helman
4.7 • 602 Ratings
🗓️ 29 March 2016
⏱️ 26 minutes
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| 0:00.0 | I'm Anton Helman, and I'm Teresa Chinn. |
| 0:08.8 | And this is the Journal Jam podcast, where we blend interviews with leading researchers of important emergency medicine journal articles |
| 0:17.6 | and the best of crowdsourced social media-based opinions of emergency |
| 0:22.0 | medicine providers from around the world. |
| 0:28.9 | Dogma is everywhere in medicine. |
| 0:31.0 | I think a big part of this is because we learn by a lot of legacy teaching. |
| 0:34.7 | And that's because when we first enter into medicine, there's so much to learn |
| 0:38.5 | that you have to try to figure out some shortcuts and rules. But then once you get to the level |
| 0:44.2 | that we're playing at where we're practicing physicians, we need to start maybe thinking about |
| 0:48.9 | the dogma again and questioning a little bit. Yeah, when it comes to corneal abrasions, you know, I've been told countless times by |
| 0:57.2 | ophthalmologists and even my ED colleagues never to prescribe topical anesthetics for |
| 1:03.0 | corneal abrasion patients with the reason being theoretical, really, that tetrican and the like |
| 1:08.4 | will inhibit re-epathelialization and therefore delay epithelial healing. |
| 1:14.3 | Now, this might be true for the tetrican abuser who pours the stuff in their eye for weeks on end, |
| 1:20.8 | but when you look at the literature for toxic effects of using topical anesthetics in the short term, |
| 1:27.1 | you know, for a couple of days after |
| 1:28.4 | a corneal abrasion, there is a total of, ready for this, one patient from one case report. In other words, |
| 1:37.3 | there's really no evidence for any clinical important detrimental outcomes when it comes to the |
| 1:41.9 | short-term use of topical anesthetics for corneal abrasions. |
| 1:45.8 | The question is, should we ignore the dogma and use tetra cane anyway? |
| 1:51.5 | Another way to ask a question is, is there evidence that the use of topical anesthetics after |
| 1:56.8 | coronial abrasion is safe and effective for pain control without adverse effects or delayed |
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