by butterfly

Created on: July 04, 2007

Check the practitioner's order. Identify the patient and explain the procedure.
Assemble your supplies. Ensure that the irrigation solution is at or near body temperature (32-37 degrees C). Check it with a bath thermometer.
Wash your hands and don gloves.
Instruct the patient to alert you if he becomes nauseated or dizzy, or experiences pain. (STOP the irrigation if the patient experiences any of these symptoms and notify the health care practitioner.)

Position the patient. He may sit up or lie on his back. Cover his shoulder and arm with a towel or moisture proof pad. Inspect the auditory canal and remove any visible debris with cotton-tipped applicator.
Place an emesis basin under his ear and have him tilt his head toward the affected side. (The patient can hold the basin for you.)Pull gently on the auricle to straighten the ear canal. On an adult pull up and straight back. On a child, pull down and back on the pinna.
Fill the syringe and expel any air. Insert the bulb syringe at the meatus of the auditory canal, but do not occlude the meatus.
The tip of the syringe should be pointed upwards toward the posterior ear canal to avoid pushing any debris further into the ear canal. This will also help to direct the flow of solution so that you avoid directly hitting the tympanic membrane.
Irrigate with a steady gentle stream of solution. Don't force the solution if you meet resistance.
Continue the irrigation until all of the solution is has been used. (Don't use more than 500 cc.)Inspect the returned fluid for cerumen, foreign objects, color and amount.
Dry the ear and position the patient on his side so that remaining fluid may drain. You may loosely place a cotton ball or 4X4 in the ear meatus to collect fluid. Have patient lay on his side for about 10 minutes. Inspect the drainage.
Assess patient for hearing acuity changes, pain, dizziness, nausea.
Document the procedure. Include the date and time, the solution used, including the amount and temperature, the results obtained, and the patient's response.
Tips:
The solution should be at or near body temperature (32-37 degrees C). It should be a sterile solution in case the tympanic membrane is or becomes ruptured.
Never use more than 500 cc of solution.
Never irrigate the ear if the eardrum is known to be perforated or the patient has tubes in the ear.

What You Need:
Irrigation solution and sterile basin if needed
Ear syringe
emesis basin
gloves
towel and moisture proof pad
cotton balls or 4X4s
cotton-tipped applicators
bath thermometer

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