Irrigation
Irrigation
Irrigation
Introduction:
The ear naturally secretes wax to protect and lubricate the ear as well as to keep
debris out and hinder bacterial growth. Under normal conditions, the body
keeps the amount of earwax in the ears under control. Cerumen accumulation
is normal and does not require treatment unless it is symptomatic. Too much
earwax or hardened earwax can cause a blockage in the ear, resulting in
earaches, ringing in the ears, or temporary hearing loss. Wax is usually
described as impacted if it obscures visualization of the tympanic membrane
and is associated with symptoms.
112
it harder to remove and may put more pressure on the eardrum,
increasing risk of perforation. In some cases, fluid becomes
trapped in the ear canal and causes an increase in pressure that
can rupture the eardrum.
• Temporary dizziness,
• Tinnitus, or
113
3. Irrigation, or ear syringing, should be performed only after taking
a full history, doing an ear examination and explaining the
potential complications to the patient.
114
4. Gentle irrigation of the ear canal can be performed with a large
syringe (20 ml with rounded nozzle) and warm water.
5. The tip of the syringe should not pass the outer one-third ofthe ear
canal (approximately 8 mm).
1. Natural oils: Olive oil, baby oil, and mineral oil are all commonly
used as an alternative remedy for medical ear irrigation. Put a few
drops of oil in the affected ear canal, which will soften the wax.
These oils are typically nonirritating. After the oil has soaked for a
few minutes, the patient can lie with the affected ear face down on
a soft cloth to let it drain out.
2. Salt water: Salt water can also be used as eardrops to soften and
remove earwax. Let the salt water sit in the ear for three to five
minutes before placing the ear facedown to let the saline solution
drain. Clean the ear and any wax in the outer ear canal with a soft
cloth.
115
3. Mixtures and solutions: Both hydrogen peroxide and a mixture of
vinegar and rubbing alcohol are alternative remedies that can
116
be used to remove earwax. They can soften earwax. They're
generally regarded as safe and effective, as long as the eardrum
is fully intact, though some patients may find them irritating.
Preparation
a. Equipment.
• Prescribed irrigating solution (warmed to 370C)
• Irrigation set (container and irrigating or bulb syringe)
• Waterproof pad
• Emesis basin
• Cotton-tipped applicators
• Disposable gloves
• Cotton balls
• Medication Administration Record (MAR)
• Hear Earwax Remover Kit, Includes: Ear Drops to Soften Ear
Wax, Wash Basin, 3 Soft Disposable Tips, Irrigation
System to Clean Outer Ear
b. Solutions:
Tap water.
117
Normal saline.
Hydrogen peroxide and water.
118
Bicarbonate of soda and water.
Prescribed medication—mix solution, if required.
Oil (used to make the foreign matter slippery and easy to
expel).
Pre Procedure:
1- OTO SCOPE
The otoscope is an instrument used to view the external auditory canal. The
speculum is an attachment to the otoscope to inspect inside the external ear
canal.
NOTE: Cold solutions are uncomfortable and may cause dizziness or nausea
as a result of stimulation of the equilibrium sensors in the semicircular canals.
3. Insert the Oto scope speculum into the external ear canal.
1. Assist the patient to assume the position, which allows a good view.
2. Tip the patient's head toward the opposite shoulder or ear to be
irrigated.
3. Straighten the external ear canal by gently pulling the auricle upward
and backward
119
Figure 3. Straightening the external ear canal
4. Turn on the oto scope light and insert the speculum just inside the
opening of the ear
• Check the external ear canal for redness, swelling, drainage, or foreign
bodies.
120
• Normally, a blue, yellow, amber, red, or pink eardrum indicates disease
of infection.
NOTE: eardrum is normally shiny and pearly. A hole or tear in the ear
should be reported to the supervisor. Straighten auditory canal by
pulling the inna u and back.
Rationale
Procedure:
To identify patient and prevent
Action medication errors.
Gather equipment; Check the patient•s medication
char for allergies. To prevent the spread of microor anisms.
This is the most reliable method.
Perform hand hygiene and wear gloves.
Check name and identification number on the Exp non ac •tates cooperation an
patient•s identification band and ask the patient to reassures tient
state his name Explain procedure to patient
121
Direct a stea y, s ow stream o so ution against the Prevent Injury to t e tympanic
roof of the auditory canal using only enough membrane. Continuous in-and-out flow
force to remove secretions. of the irrigating solution helps to
122
Evaluate the patient's response to the procedure. The patient needs to be evaluated for
Return in 10 to 15 minutes and remove cotton therapeutic and adverse effects from the
ball and assess draina e. medication.
123
Post procedure: REPORT AND RECORD PROCEDURE
124
Ear Irrigation
Student name: Date:
Action Allotted Done Done Not
de com tend Incom ten done
Preparation:-My self
Check the patient's 1
medication chart for
aller •es.
wash hands 1
put on clean gloves
Preparing equipment:
a. Equipment. 1
• Prescribed irrigating
solution (warmed to 370 C)
•Irrigation set (container
and irrigating or bulb
syringe)
• Waterproof pad
• Emesis basin
• Cotton-tipped
applicators
• Disposable gloves
• Cotton balls
Medication
Administration Record
125
b. Solutions:
• Tap water.
Normal saline.
Prescribed medication—
126
Place a waterproof pad and 1 ask the
patient to support basin under the ear
to receive the irrigating solution
Procedure
Clean pinna and meatus of
auditory canal with
moistened cotton-tipped
applicators dipped in warm
tap water or the irrigating
solution
127
Student signature: Instructor signature:
128