Ocular injury due to foreign bodies and chemicals has the ability to cause ongoing discomfort and permanent injury to the eye. Flushing with water for a suitable period of time has the ability to reduce or eliminate further injury and damage.

Foreign body irritant due to:

  • Dust
  • Smoke particles
  • Other foreign bodies that are on the surface of the eye

Ocular injury due to:

  • Acid or solvent burns
  • Gasoline
  • Detergents
  • Alkali burns
  • Chemical splashes
  • Oleoresin Capsaicum (OC), capsicum or pepper spray
  • Penetrating eye injuries
  • Suspected or actual rupture of the globe
 Patient Factors & Considerations
  • Use normal saline (NaCl 0.9%) preferentially, or clean, potable water if there is no saline available
  • Irrigation solution should be tepid; too cold or hot could cause further damage to the eye and surrounding fluid.
  • Minimise the application pressure. This should be enough to gently shower and flood the eye. Avoid high pressure at all times.


  • Explain procedure to patient and gain consent where applicable
  • Perform hand hygiene and don all relevant PPE 
  • Maintain aseptic technique throughout procedure 
  • Consider Ondansetron (as vomiting may cause an increase in intra-ocular pressure)
  • Consider requirement for analgesia 
  • Place clean absorbent pad underneath patients head (ensure spinal immobilisation maintained if required)
  • Position patient supine with 30° head elevation to reduce intra-ocular pressure (unless hypovolemic) 
  • Tilt patients head slightly towards side of affected eye (to ensure irrigation of irritant/ chemical is away from non-affected eye). If spinal immobilisation required or both eyes affected, maintain supine positioning and attempt to irrigate contents laterally
  • Test temperature of irrigation fluid prior to irrigation (best to use room temperature)
  • Ask patient to fix their gaze

Prepare the equipment

  • Absorbent pads
  • Combine dressing
  • 1 litre NaCl 0.9%
  • 20 ml syringe


  • For foreign body irritant:
    • Draw up Normal saline (NaCl 0.9%) into 20ml syringe 
    • Open the eyelid/s (if possible), ensuring not to touch the conjunctiva with hands 
    • From no more than 5 centimetres away, irrigate saline into front surface of the eye and inside the lower eyelid
    • Ask patient to move eye in all directions during irrigation
    • For foreign body irritant use 20ml syringe to clear foreign body
    • Absorbent pads / combine dressings can be placed next to patients’ cheek to absorb the irrigated fluid
  • For chemical injury:
    • Setup IV giving set using the 1 litre normal saline (NaCl 0.9%) bag
    • Open the eyelid/s (if possible), ensuring not to touch the conjunctiva with hands 
    • From no more than 5 centimetres away, gently irrigate saline into front surface of the eye, under the upper eyelid and inside the lower eyelid. 
    • Ask patient to move eye in all directions during irrigation
    • For chemical injury use IV giving set to for copious Irrigation as early as possible, for a minimum of 30 minutes. This should not delay transport.
    • Absorbent pads / combine dressings can be placed next to patients’ cheek to absorb the irrigated fluid

Where eye irrigator is available*

*Staff must be trained and authorised in use.

  • Locate the eye wash station
  • Twist the irrigator clockwise to open the saline bottle
  • Remove the dust cap on te applicator
  • The head should be pointed downwards to assist with drainage and avoid spent fluid entering the bottle
  • Hold the eye(s) open with the fingers
  • Begin to flush the eyes
  • Have the patient gently roll their eyes from left to right and up and down to be sure that all areas of the eyes are flushed

In the event of a chemical injury:

  • flush for a full 15 minutes to allow appropriate dilution and clearance.

In the event of ongoing discomfort or injury:

  • The patient should be referred to a specialist physician for follow up.
Eye Wash
Additional Information
Additional information

Extended Care:
Colour assist:

Document Control

Clinical Services

Responsible Manager
Head of Clinical Services


Published Date

Review Date

Clinical Resources Website

St John Ambulance Western Australia Ltd (ABN 55 028 468 715) (St John WA) operates ambulance and other pre-hospital clinical services. St John WA’s Clinical Resources, including its Clinical Practice Guidelines (Clinical Resources), are intended for use by credentialed St John WA staff and volunteers when providing clinical care to patients for or on behalf of St John WA, within the St John WA Clinical Governance Framework, and only to the extent of the clinician’s authority to practice.

Other users – Terms of Use

The content of the St John WA Clinical Resources is provided for information purposes only and is not intended to serve as health, medical or treatment advice. Any user of this website agrees to be bound by these Terms of Use in their use of the Clinical Resources.

St John WA does not represent or warrant (whether express, implied, statutory, or otherwise) that the content of the Clinical Resources is accurate, reliable, up-to-date, complete or that the information contained is suitable for your needs or for any particular purpose. You are responsible for assessing whether the information is accurate, reliable, up-to-date, authentic, relevant, or complete and where appropriate, seek independent professional advice.

St John WA expressly prohibits use of these Clinical Resources to guide clinical care of patients by organisations external to St John WA, except where these organisations have been directly engaged by St John WA to provide services. Any use of the Clinical Resources, with St John WA approval, must attribute St John WA as the creator of the Clinical Resources and include the copyright notice and (where reasonably practicable) provide a URL/hyperlink to the St John WA Clinical Resources website. 

No permission or licence is granted to reproduce, make commercial use of, adapt, modify or create derivative works from these Clinical Resources. For permissions beyond the scope of these Terms of Use, including a commercial licence, please contact medservices@stjohnambulance.com.au

Where links are provided to resources on external websites, St John WA:

  • Gives no assurances about the quality, accuracy or relevance of material on any linked site;
  • Accepts no legal responsibility regarding the accuracy and reliability of external material; and
  • Does not endorse any material, associated organisation, product or service on other sites.

Your use of any external website is governed by the terms of that website, including any authorisation, requirement or licence for use of the material on that website.

To the maximum extent permitted by law, St John WA excludes liability (including liability in negligence) for any direct, special, indirect, incidental, consequential, punitive, exemplary or other loss, cost, damage or expense arising out of, or in connection with, use or reliance on the Clinical Resources (including without limitation any interference with or damage to a user’s computer, device, software or data occurring in connection with such use).


Please read this cookie policy carefully before using Clinical Resources from St John WA.

The cookies used on this site are small and completely anonymous pieces of information and are stored on your computer or mobile device. The data that the cookies contain identify your user preferences (such as your preferred text size, scope / skill level preference and Colour Assist mode, among other user settings) so that they can be recalled the next time that you visit a page within Clinical Resources. These cookies are necessary to offer you the best and most efficient possible experience when accessing and navigating through our website and using its features. These cookies do not collect or send analytical information back to St John WA.

Clinical Resources does integrate with Google Analytics and any cookies associated with this service enable us (and third-party services) to collect aggregated data for statistical purposes on how our visitors use this website. These cookies do not contain personal information such as names and email addresses and are used to help us improve your user experience of the website.

If you want to restrict or block the cookies that are set by our website, you can do so through your browser setting. Alternatively, you can visit www.internetcookies.com, which contains comprehensive information on how to do this on a wide variety of browsers and devices. You will find general information about cookies and details on how to delete cookies from your device. If you have any questions about this policy or our use of cookies, please contact us.

St John Ambulance Western Australia Ltd © Copyright 2020, All Rights Reserved

Terms of Use | Privacy Policy | Copyright Statement & Disclaimer