Ear Irrigation - PowerPoint Presentation

Slide1

Ear Irrigation

Rhian Smith

Community Health Nursing Clinic

Skill PresentationSlide2

Equipment for Irrigation

Irrigating Syringe

Prescribed Irrigating Solution or Tap Water

2 Basins: 1 Round and 1 CurvedAbsorbent Pad or TowelCotton BallSlide3

Preparation for Irrigation

Verify Physician’s Orders

Hand Hygiene

Gather Necessary EquipmentWarm Irrigating Solution to Body TemperatureRational: Nausea and vertigo can occur if the irrigating solution is cold

Note: If wax softening eardrops are prescribed, ensure that the client has instilled them several hours prior to procedureSlide4

Essential Information

Only perform ear irrigation if the tympanic membrane can be visualized. Debris has the potential to cover unseen perforations.

Ensure intactness of the client’s tympanic membrane before beginning the irrigation.

Do NOT use water to remove organic foreign bodies from the ear. Water can cause swelling of the objects.Examples:

Insect BeanSlide5

Procedure

1. Common Procedure Initiation

ID client via name band, client statement of name and date of birth, provide privacy, explain procedure, acquire clean gloves

2. Place client in Fowler’s position. Place absorbent towel over client’s chest and shouldersSlide6

Procedure Continued

3. Place irrigation solution in round basin

4. Place curved basin under client’s ear to catch irrigating solution

5. Fill syringe with irrigating solutionSlide7

Procedure Continued

6. Open and straighten client’s ear canal

Adults: Pull pinna up and back

Infants and Children: Pull pinna downwardRational: Opens ear canal to allow solution to flow inSlide8

Procedure Continued

7. Hold irrigating syringe at entrance of ear canal without occluding meatus.

Rational: Fully entering the ear canal can cause impaction

8. Push plunger with flow of solution directed towards the top of the canal

Rational: Allows the flow to reach the entire length of the canalSlide9

Procedure Continued

9. Monitor return flow

10.Dry outside of the ear once the solution has stopped flowing

11. Return client to a comfortable position and place cotton ball in ear canal to absorb excess fluid.Rational: Reduces risk of external otitis12. Return equipment, remove gloves, perform hand hygiene and document resultsSlide10

Outcomes

Expected: Removal of Cerumen

Unexpected: Nausea and vertigo experienced by client during procedure.

To prevent future occurrence:Ensure fluid is properly warmed prior to irrigationSuggest use of wax-softening ear drops Slide11

Application to the Home Setting

Title:

Managing Earwax in Primary Care: Efficacy of Self Treatment using a Bulb Syringe

Purpose: Compare effectiveness of in-office irrigation and at-home bulb syringe irrigationEnsure client is aware of proper at-home procedure previously discussed

Results of Study:41% of bulb syringe users received adequate removal of earwax51% of bulb syringe users did not require repeat irrigationLess than 1% received trauma to the ear during the irrigation

If completed correctly at home ear irrigation can save time and money for the clientSlide12

QUESTIONS?Slide13

References

Coppin, R., Wicke, D., & Little, P. (2008). Managing earwax in primary care: Efficacy of self-treatment using a bulb syringe.

British Journal of General Practice, 58,

44- 49.Smith, S.F., Duell, D.J., Martin, B.C. (2008)

Clinical nursing skills: Basic to advanced skills (7th ed.). New Jersey: Pearson Education, Inc. All images retrieved using Goggle search