RTS - Ear Flashcards
What are symptoms of outer ear infections?
itch
pain
discharge
deafness
What are symptoms of middle ear infections?
discharge
deafness
dizziness
What are symptoms of inner ear infections?
deafness
dizziness
tinnitus
What could cause excess cerumen/ear wax?
physical structure of the external auditory canal
excess production of cerumen
abnormal secretions - drier or softer
impaction
attempt to clean the ear
- wax becomes trapped, stopping its outward migration
What are symptoms of excess cerumen?
wax can be ‘wet and sticky’ or ‘dry’
hearing loss blocked ears ear discomfort - should not be pain itchiness water - can cause expansion of the earwax which may result in complete blockage of the ear canal
What are specific questions to ask for excess cerumen?
course of symptoms associated symptoms - pain, dizziness, tinnitus activities/ trauma to ear use of previous medicines - refer if they have not worked
What are practical measures for excess cerumen?
do not insert foreign objects to clean
- cotton buds
no ear candling
What are treatments for excess cerumen?
Oil based - allergy risk
- cerumol = olive, peanut
- earex - olive
- oil softens it as cerumen is hydrophobic so soluble in oil
Water-based cerumenolytics
- molcer, waxsol - docusate sodium
- increase water penetration to soften ear wax
Peroxide based
- sodium bicarbonate
- otex and exterol = urea hydrogen peroxide, glycerol
- effervesce with trapped water within wax, causing mechanical removal by ‘popping’
When should excess cerumen be referred?
children and elderly - caution
pain in middle ear
mucinous discharge
trauma related deafness/redness/ swelling
dizziness/tinnitus - inner ear
foreign body - cotton buds used
failure in OTC - did they adhere to treatment, recurrent or not,
How to administer ear drops?
wash hands before and after use
warm the bottle in your hands for a few minutes before
tilt head to one side and straighten ear canal
adult - pull pinna up and back
children - pull pinna down and back
hold bottle close but do not let the dropper touch the ear
hold head in tilted position for a few minutes
What is otitis externa?
inflammation of the external ear - swimmers ear
causes by
- excess water or repeated contact with water =swimmers are more likely to get it
- inadequate cerumen
- dermatological conditions = psoriasis, seborrhoeic dermatitis
What are symptoms of otitis externa?
itching and irritation scratching may result in trauma and pain swelling, redness, eczematous ear discharge - watery temporary deafness
What are specific questions to ask for otitis externa?
pain and irritation present? fever and cold symptoms present? - should not have systemic symptoms - suggest it could be otitis media discharge - mucus or watery (should be watery) recurrent or first time
What are practical measures for otitis externa?
avoid cotton buds and scratching
avoid getting water, soap or shampoo into the ear when showering
dry with a hairdryer not a towel
swimmers
- ear plugs
- swim caps
- protective drops = swim seal
When should otitis externa be referred?
children long duration - symptoms persist for more than 7 days after treatment initiation significant mucous discharge pain in mastoid area slow growing growth on pinna systemic symptoms - fever generalised inflammation on pinna
