Treatment of Corneal Abrasions
Dear Colleagues:
| OMIC wishes to bring to your attention an important discussion regarding treatment of simple corneal abrasions with topical anesthetic.The American College of Emergency Physicians (ACEP) recently published guidelines regarding the treatment of simple corneal abrasions, in which it concluded that “…for only simple corneal abrasions, as diagnosed and treated in accordance with the full protocol described herein, it appears safe to prescribe or otherwise provide a commercial topical anesthetic (i.e., proparacaine, tetracaine, oxybuprocaine) for use up to every 30 minutes as needed during the first 24 hours after presentation, as long as no more than 1.5 to 2 mL total (an expected 24-hour supply) is dispensed and any remainder is discarded after 24 hours.” [1]
In a response[2], the American Academy of Ophthalmology respectfully disagreed with the ACEP recommendations and conclusions, citing a lack of robust supporting data. It further noted that a 2023 Cochrane study on the use of topical anesthetics for corneal abrasion concluded that there was little evidence to predict the safety and efficacy of such treatment. In conclusion, the AAO opined that to insure patient safety, more rigorous scientific studies that include ophthalmologists are needed before guidelines can be issued. You may wish to consider the following treatment guidelines presented in a February 2024 EyeNet Cornea Clinical Update article, “Topical Anesthetics: The Latest on Use for Corneal Abrasions,” which offers a “three As” mnemonic device when treating corneal abrasions in the emergency department[3]:
We hope that this information will be helpful to you. Sincerely, Robert S. Gold Michael Tigani, MD Andrew Iwach, MD ______________________________ |
Telephone Screening
April 8, 2024
Dear OMIC Insureds:
You rely on your staff to screen countless calls from patients each day. Having your employees ask patients the correct questions when they call to report a problem or seek advice will ensure calls are being handled appropriately. The materials in OMIC’s Telephone Screening Toolkit should be used as a guide to develop and implement a screening protocol for your practice. OMIC suggests the following recommendations to promote both the continuity and defensibility of telephone care:
- Exercise the same care when treating a patient over the telephone as you would during an office visit.
- Gather the information necessary to assess the situation and determine the treatment plan.
- Communicate the assessment and plan to the patient.
- Document the encounter and your decision-making process in the medical record.
- Develop written protocols for telephone screening and treatment that are specific to your patient population, subspecialty, and staff.
- Supervise staff members who screen calls. In addition to developing and approving written protocols, the supervision should include:
- Training and verification of competency.
- Answering questions from staff members unsure of how to handle specific calls.
- Regular review of how calls are handled and documented (e.g., patient complaint, type of appointment, staff advice, etc.), and
- periodic review of the screening protocols themselves.
If you have questions, contact us for confidential risk management advice at riskmanagement@omic.com or call us at 1-800-562-6642 and enter 4 for Risk Management.
Sincerely,
Amy Braswell
OMIC Risk Management Specialist
