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Ear Wash (Irrigation)Considerations:
1. Ascertain if patient has a history of tympanic membrane perforation
or other complications that would contraindicate ear irrigation. If such history exists, consult with health care provider before
proceeding.
2. For adults, pull auricle up and back to straighten auditory canal.
For pediatric patients, pull auricle down and back to straighten auditory
canal.
3. Determine what is to be irrigated from ear. If object absorbs water, then it may swell during procedure
exacerbating symptoms or causing pain.
4. Be prepared for patient to become dizzy, especially if cool water
is used to irrigate. This is
a common side effect of ear irrigation.
Before
beginning:
1. If not already available, begin warming solution to be used. Use of cold water is uncomfortable to the patient and may even be
painful due to spasms it can cause - especially in geriatric patients. Solution should not be hot to the touch.
2. Consider use of cerumenolytic solution to soften or loosen any
suspected impaction. Instillation
at this point will allow time for solution to take effect while you
prepare for irrigation.
3. Set up protective toweling and/or basin to collect drainage
water/solution.
4. Other equipment to have at bedside includes:
5. Place the patient in a position of comfort that has them either
sitting or lying down and head tilted toward ear to be irrigated.
Procedure:
1. Use a cotton tipped applicator or ear pick to remove any visible
debris or discharge near auditory canal opening.
2. Gently place tip of irrigation device at the opening of the
auditory canal and gently direct stream of water against the sides of the
auditory canal so as to allow the force of the irrigation solution to
reflect behind the object and “push” it out. Do not direct stream directly at the object as you may only
drive it in deeper. If an
irrigation drainage bag is used, allow no more than a six inch (fifteen
centimeter) elevation above the auditory canal.
3. Dry external ear and place patient in a position of comfort with
irrigated ear facing downward so as to allow any remaining irrigation
solution to drain by gravity.
4. Record procedure and results, including solution(s) used, length of
procedure, and patient response.
Reference: Nettina, Sandra M., (1996) The lippincott manual of nursing practice (6th ed.) pp 464-465. Lippincott: Philadelphia. This section contributed by Patrick Myer RN, BSN, CEN, Emergency Medicine Department, Naval Medical Center, Portsmouth, Virginia
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*This web version is provided by The Brookside Associates, LLC. It contains original contents from the official US Navy NAVMED P-5139, but has been reformatted for web access and includes advertising and links that were not present in the original version. The medical information presented was reviewed and felt to be accurate in 2001. Medical knowledge and practice methods may have changed since that time. Some links may no longer be active. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense.
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