checklist for ear irrigation with water for ear irrigation with water ... you should also follow...
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Primary care essentials • 2718 July 2014
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Checklist for ear irrigation with waterThis is a guide to assist your clinical judgement in irrigation. You should also follow local guidelines and be trained in ear care.
Patient name DOB Date Address
Has the patient had their ears irrigated with water before yes / no
Irrigation with water should not be performed without valid consent and if the patient has any of the following signs and symptoms:
Yes NoExperienced any complications from a previous irrigationHad a middle ear infection (Otitis Media) in the last 2 months Undergone any form of ear surgeryHas a perforation or there is a history of mucous discharge from the ear in the last 2 yearsA cleft palate (repaired or not)Presence of acute otitis externa (pain, swollen canal and tenderness of the pinna)Profound hearing loss in one ear
Ensure the wax is not too hard when irrigating in the following vulnerable groups
Yes No
Anti-coagulants
Diabetes
Tinnitus
Vertigo
Radiotherapy that has involved the ear canal
Ear preparation
Duration
Ensure irrigator has been decontaminated prior to that day’s use following local guidelines and a new disposable tip is clicked into place for each patient.
After 15 seconds of irrigation stop and ensure the patient is comfortable with no symptoms of water entering the middle ear. Continue irrigation if there are no concerns.
RED FLAG: Stop irrigation if the patient feels the sensation of water in the nose or throat or if they become very dizzy or the procedure becomes painful.
PHYSICAL EXAMINATION OF BOTH EARS
Pinna
Ear canal entrance
Adjacent scalp
Right LeftYes No Yes No
Light reflex present? Handle and lateral process of Malleus visible?Pars flaccida distinguished?
Normal Pars Tensa?
It is recommended that all water is removed from the ear canal on completion of the irrigation procedure and prior to a final ear examination
Any irregularities.
Result of irrigation
Hearing Concern Yes / No
Referral to GP or audiologists for further
assessment Yes / No
Referral to ENT specialist Yes / No
Print name and title
Signature
Ear Care.indd 27 09/07/2014 10:02