Some individuals produce an excess of earwax. In some cases a blockage or impaction of cerumen can occur, and the ear may need to be irrigated to clean the canal out.
Ear infections (acute otitis media) occur when fluid becomes trapped in the middle ear. Pressure can build up causing pain and diminished hearing on the affected side. Antibiotic drops can be used to treat the infection. Educate the patient to administer medication as prescribed and to finish antibiotic therapy.
To straighten out the ear canal in children less than 3 years of age the Pinna/Auricle (outer part of ear) needs to be pulled back and downwards. This allows for a drop to be more accurately administered into the ear allowing gravity to pull it down. “Child” has the letter “D” for Downward.
To straighten out the ear canal you need to pull the Pinna/Auricle (outer part of ear) back and upwards for adult patients. This allows for a drop to be more accurately administered into the ear canal allowing gravity to pull it down. “Adult” has a “U” for Upward.
To allow for gravity to assist the medication into the middle ear, place the patient on the side with the ear facing up.
When administering a drop, hold the dropper about 1 cm (1/2 inch) above the ear canal, while holding the Pinna in the proper position. Do not touch the tip of the dropper with your hands or touch the patient. The solution is sterile, and the tip needs to be kept clean.
To allow the medication time to travel to the middle ear and not drain out; keep the patient in the side lying position or keep the ear facing upward for 2-3 minutes.
The inner ear is sensitive to temperature changes. To prevent vertigo, dizziness, or nausea make sure the solution is kept at room temperature.
To help disperse the medicine in the ear, you can gently massage the tragus, unless contraindicated because of pain.
If drainage is present, confirm that the patient’s eardrum is not perforated. This would be a contraindication for administering the ear drops. If irrigating the ear canal, never put syringe directly into canal or forcefully put medication in ear canal. The pressure could perforate the eardrums.
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