Ear irrigation info

Ear irrigation is the process of flushing the external ear canal with sterile water or sterile saline. It is used to treat patients who complain of foreign body or cerumen (ear wax) impaction. The purpose of ear irrigation is to remove earwax that is obstructing the ear canal or to remove a foreign object lodged in the ear canal. Ear irrigation is most commonly performed on those who experience a wax build-up that has impaired hearing and irritated the outer ear canal. Ear irrigation is performed in the emergency department as a first-line treatment for a foreign object in the ear canal, because it is less invasive than using an instrument. If the object is a live insect, oil is inserted into the ear to kill the insect; then, the ear canal is irrigated to remove the dead insect. Some for eign objects may be removed from the ear using irrigation alone, but most require a combination of both irrigation and the use of instruments by the physician. The ear canal should be examined with an oto-scope prior to ear irrigation. Ear irrigation is not recommended if the eardrum is ruptured, because the procedure may force bacteria through the perforation into the inner ear. Ear irrigation is not used in patients with fever and ear pain, as these symptoms may indicate an inner ear infection. If a foreign object is made of vegetable matter (e.g., a bean or pea), irrigation is avoided because the water will cause the object to swell and complicate extraction of the object.prefer to attach a large bore IV (intravenous) catheter (with the needle removed) to the syringe for easier direction of the fluid. Using this method, the fluid is aspirated into the syringe and squirted into the ear canal. Another method uses IV solution and tubing, with a disposable ear irrigation connector that fits onto and over the outer ear. When using this method, the IV is turned on and the fluid flows by gravity into the ear to create the irrigation. When using the IV method, the bag should be about 6 inches (15 cm) or less above the patient's head to create the proper fluid pressure. After positioning the patient, the earlobe of the affected ear should be held back, and up (back and down for an infant). The tip of the irrigation syringe or catheter should be placed at the entrance to the ear. The tissue of the ear should not be touched. The ear canal should not be occluded, or the solution will not be able to run back out of the ear. Gently aiming the flow of the irrigation solution towards the upper aspect of the external ear canal, the nurse should syringe or run in the IV fluid at a slow, steady rate, allowing the fluid to escape out of the ear canal and into the basin. If using a dental pik apparatus, the lowest setting should be used. Exerting too much pressure can force the foreign object or the wax occlusion deeper into the ear canal. The return fluid should then be checked before the syringe is refilled-or after 100cc of fluid for an adult, and 30cc of fluid for a child. The nurse should investigate whether the wax or foreign object has been flushed from the ear. When the obstruction has been removed, 500cc of irrigation fluid should be used for an adult-100cc for a child, or as ordered by the physician. The procedure should be interrupted if the patient complains of pain or dizziness. Ear irrigation can be performed using a 50–60-cc syringe (20–30-cc syringe for children). Complications of an ear irrigation are rare, but may include trauma to the external ear canal, external ear infection, pain, nausea, or vertigo. Forceful irrigation with high pressure can rupture the eardrum and force bacteria into the inner ear.