Otic Flashcards
What is cerumen
oily secretions from exocrine glands and milk/fatty fluid from apocrine
also known as earwax
What is the purpose of cerumen
cleans and protects the external auditory canal (EAC)
Has acidic pH so helps protect against/fungal growth
What is cerumen impaction
accumulation of cerumen that causes symptom’s or prevent ear canal/tympanic membrane assessment
What are some causes of cerumen impaction
genetic factors
health conditions such as eczema and seborrhea
ear appliances being used
poor skin/ear hygeine
What are the presenting symptoms of cerumen impaction
feeling of pressure or fullness in ear
slow hearing loss
tinnitus
vertigo
itching
lowered tympanic membrane temp
possible dull pain
When should some not self-treat cerumen impaction
bleeding/trauma
can’t follow instructions
health conditions of the ear canal or outer ear
ear surgery in prior 6 weeks
infection
less than 12 years old
pain and ear discharge
rupture tympanic membrane
tubes or structural abnormality present in ear
worsening of symptoms after trialed self-care
What are some non-pharmacologic options that someone can try if they are experiencing cerumen impaction
- soften cerumen with body temp water then irrigate with rubber bulb otic syringe
- hygeine with wet, soapy washcloth
*do not do ear candling
**avoid cotton tipped swabs because it can worsen impaction
How do you use the otic bulb syringe
point nozzle at wall of ear canal
pull helix up and back for adults
What is the MOA of carbamide peroxide in glycerin
carbamide peroxide: effervescence/mechanical loosening and weak antibacterial
glycerin: soften and penetrate cerumen to loosen it
What is the dosing of carbamide peroxide
place 5-10 drops into affected ear and let dwell for 15 minutes
do this twice a day for a max of 4 days
flush with water afterwards
What is the MOA of hydrogen peroxide
releases oxygen when exposed to moisture
weak antibacterial
What is the dosing of hydrogen peroxide for ear flush
mix 1:1 solution of warm water and 3% peroxide
use as ear flush and/or irrigation as directed
What are causes of water clogged ears
excessive EAR hair growth
Ear canal shape
Excess cerumen/cerumen swelling
High-humidity climate
Diaphoresis
Swimming
Bathing/showering
What are the presenting symptoms of water-clogged ears
wetness, fullness in the ear
hearing loss/muffled sounds
vibration or sounds of “small rocks/pebbles” rolling around
can predispose to maceration
What are the exclusions of self-treatment for water clogged ears
same as cerumen impaction except no age exclusion
**CRITICAL TO MAKE SURE NO TUBES OR PERFERATION
