NOPRESS EYE PROTECTION SHIELD

NoPressTM is a foam and rigid plastic shield designed specifically to protect anaesthetised patient’s eyes from externally applied pressure. Its patented unitary design and midline flexion device means it resists a high pressure load while still conforming to the patient’s face.

Key Features

  • Thick medical grade foam is soft on patient’s face
  • 3M hypoallergenic adhesive allows easy, safe application and removal
  • Transparent shield allows you to see patient’s eyes
  • Single shield distributes applied pressure more evenly across orbital ridges, thus reducing force per unit area
  • Midline nasal flexion device and pre-curved shield ensures excellent facial conformity
  • Small holes on each side prevent condensation
  • Adhesive maintains position on face
  • Low profile means less likely to catch on anything.

Surgical Use

In many surgeries on the upper half of the body eg Ear, Nose and Throat (ORL), Dental, Maxillo-Facial, Upper Gastointestinal, Cardio-Thoracic, Neurosurgery, some Orthopaedics and Plastics or where the patient is prone or laterally positioned; there is an increased risk of accidental pressure being applied to an anaesthetised patient’s eyes1.

Once the patient is draped, surgical retractors, head supports, surgical assistants or the surgeons themselves may lean or rest on the eyes.

By decreasing eye injuries, all practitioners, their institutions and most importantly, their patients, will benefit.

Is Shielding the Eyes from Pressure Necessary?

In upper body surgery or prone/semi-prone positioning our patients are routinely draped and we have very limited access to inspect or touch their face. To cause eye globe morbidity a large pressure may be applied for a short period or, more easily missed, is the smaller pressure which is applied over a much longer time.

Clearly, applying sustained pressure on the eye is the same as the risk from glaucoma, and often an exterior pressure is greatly in excess of that which might be internally generated. This risk of pressure injury is increased as we age2.

The ASA Closed Claim Study found that eye injuries accounted for 3% of claims against anaesthetists. These injuries were most probably due to eye opening during anaesthesia, trauma or application of pressure to the eye1.

NoPressTM Benefits and Advantages

  • Patented design that allows flexion around nose and conformity to patient’s facial shape
  • Single plastic shield that transmits applied pressure around the patient’s bony orbital margins
  • No sharp down-facing edges which could injure underlying tissues if pressure is applied
  • Individually packaged in dust proof bag
  • Two non-stick tabs to allow easy placement, even when wearing gloves
  • 3M biocompatible adhesive
  • Transparent shield which allows user to see patient’s eyes
  • Small holes to prevent condensation.

Problems with Current Methods

Methods currently used to protect the eyes from pressure are sub-optimal.

Many practitioners or their assistants “construct” a device from two eyepads and tape. This takes time, costs money and provides a barrier to seeing the eyes and offers little protection.

There are other devices available but they often have separate compartments for each eye and this can make sizing difficult. The nature of these compartments has also led to severe eye injuries5.

Cost and Time Efficiency

Each minute of theatre time has been estimated to cost US$664NoPressTM comes ready to use and its non-stick tabs allow easy and rapid removal of the backing sheet before applying.

Because the shield is transparent it makes accurate positioning very easy.

Accidental pressure applied to an eye globe may cause serious morbidity or permanent blindness. Follow-up care in relation to diagnosis and management of such an injury may be time consuming, lead to increased discharge times and have major economic ramifications for all those involved.

References:

  1. Ranum D, Ma H. Analysis of patient injury based on anesthesiology closed claims data from a major malpractice insurer. J Health Risk Manag 2014;34(2):31-42

  2. Chadwick RG, Lindsay SM. Dental injuries during general anaesthesia: can the dentist help the anaesthetist? Dent Update 1998;25(2):76-78

  3. Newland MC, Ellis SJ. Dental injury associated with anesthesia:
a report of 161,687 anesthetics given over 14 years. J Clin Anesth 2007;19:339-345.

  4. Gaiser RR, Castro AD. The level of anesthesia resident training does not affect the risk of dental injury. Anesth Analg 1998;87:255-7

  5. Givol N, Gershtansky Y.Perianesthetic dental injuries: analysis of incident reports. J Clin Anesth 2004;16:173-176.

Disclaimer
Currently not for use in prone patients.