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I thought to share this ER hack:we used to use a tetracaine-fluoresceine combination called "Fluoracaine" and this was a refrigerated product. So... I use the smaller bottle (i think here our tetracaine is a smaller 1 use bottle than proparacaine), I pop off the spout with clean gauze, I tear off the fluoresceine strip, the colored part, and drop it into the bottle, replace the nozzle and "Whala" makeshift fluoracaine. This means I don't have to drape fluoresceine paper into an already inflamed eye. For the anxiety-ridden patients, I can ofter drip 3-4 gtts to the medial canthus of a closed eye, then help them manually prop the lid open and have the solution wash over. I tell them to look left and right, blink a few times then have a go with the Wood's lamp.Cheers! lmv
Wow! I like it! I'm going to try this next time. I'm always worried about the sting of tetracaine making then subsequent the application of fluorescein an anxious and difficult experience. Your method sounds like a good way to get it all done in one shot.
What you do matters.