Performing Otic Irrigation

Performing Otic Irrigation

Equipment
■ An ear irrigation system, such as the Welch Allyn ear wash system or an electronic jet ear irrigator.
■ Asepto syringe, or rubber bulb syringe (if an ear irrigation system is not available).
■ Irrigating solution (usually water, but may be an antiseptic solution), warmed to 98.6 F (37 C).
■ Bath towel and moisture-resistant towel.
■ A headlight if one is available.
■ Emesis basin.
■ Otoscope.
■ Cotton balls.
■ Procedure gloves.
■ Be Safe! Do not use a metal syringe, as it is considered dangerous.
■ Be Smart! An ear irrigation system is preferred over an Asepto or bulb syringe because of the better ability to control pressure and remove cerumen.

Assessment
■ Assess for pain and hearing loss.
■ Determine whether there are contraindications for ear irrigation (e.g., recent middle ear infection, cleft palate).
■ Assess the external ear for drainage, cerumen.
■ Assess the external ear canal for redness, swelling, or foreign objects; visualize the tympanic membrane.
■ Be Safe! Do not irrigate if drainage is present or you cannot visualize the tympanic membrane.
■ Be Smart! If a foreign object is present, attempt to remove it before irrigation. Post-Procedure Reassessment
■ Observe the quantity and quality of ear cerumen you removed, and the appearance of the ear canal.
■ Assess for complaints of pain or dizziness, and for improvement in hearing acuity.
■ Observe for drainage on the cotton ball.

Key Points
■ Warm the irrigating solution to body temperature.
■ Assist the patient into a sitting or lying position, with the head tilted slightly toward the affected ear.
■ Adults: Straighten the ear canal by pulling up and back on the pinna.
■ Young children: Pull down and back to straighten the canal.
■ Instruct the patient to notify you if he experiences any pain or dizziness during the irrigation.
■ Place the tip of the nozzle (or syringe) into the entrance of the ear canal, and direct the stream of irrigating solution slowly and gently along the top of the ear canal toward the back of the client’s head.
■ Continue irrigating until the canal is clean.
■ Perform an otoscopic examination.
■ Place a cotton ball loosely in the outer ear.

Documentation
■ Document:
■ The irrigation solution used.
■ The quantity, character, and odor of cerumen or drainage.
■ The condition of the ear canal and tympanic membrane after the irrigation.

Place the tip of the nozzle about 1 cm (1/2 in.) above the entrance to the

ear canal