RTS - ears

Question 1

What is ear wax?

Answer 1

oil produced by ears combines with epithelial cells in canal to form a waxy protective ear. When too much cerumen produced - obstructive waxy plug forms

Question 2

what is otitis media?

Answer 2

infection of middle ear - usually associated with a cold / flu - respiratory infection - cannot be treated in community must refer - intense pain, discharge, fever, malaise, dizziness, nausea

Question 3

what is otitis externa?

Answer 3

inflammation of the skin of the pinna or external ear canal - caused by fungus or bacteria.Common in patients with prolonged exposure to water.
- pain, fever, dizziness, malaise, fluid

Question 4

What is glue ear?

Answer 4

common childhood condition - middle ear filled with fluid - hearing loss in one or both ears.
Clears up on its own in 3 months BUT refer if its longer or if its interfering with the Childs language development

Question 5

What is tinnitus?

Answer 5

Ringing in the ear, or roaring, hissing, clicking etc.
Soft, loud, high pitch etc
Can be one or both ears
Always refer as the treatment depends on the cause

Question 6

what is vertigo?

Answer 6

sensation of spinning caused by an inner ear problem - dizzy, swaying - caused by altered activity in the balance of the internal organs so ALWAYS refer if its NOT related to a migraine

Question 7

what is a perforated eardrum?

Answer 7

hole or rupture - decreased hearing, discharge, pain
sometimes it heals spontaneously
refer if the symptoms persist with no improvement

Question 8

what are the 4 treatments for ear wax

Answer 8

1. products to loosen wax e.g olive oil, almond, arachis (caution - made with peanut oil) - cerumol
2. Urea hydrogen peroxide 5% ear drops - Exterol - instil 5 drops once or twice daily up to 4 days
3. docusate - facilitate water penetration to loosen ear wax - Waxol
4. ear irrigation

Question 9

treatments for otitis externa?

Answer 9

acetic acid 2% - instil at least 3 times a day every 2-3 hours - refer if no improvement after 48 hours.
- painkillers for fever and pain

BUT most cases need referral for antibiotics and steroid ear drops

Question 10

treatments for otitis media?

Answer 10

symptomatic relief e.g painkillers, warm flannel BUT referral for antibiotics

Question 11

Red flag referral symptoms for ears

Answer 11

severe pain
deafness / hearing loss
discharge
foreign body in ear
bleeding
suspected - vertigo, tints, otitis media, perforated ear drum

Question 12

lifestyle points for ears

Answer 12

• ear wax = dont use cotton buds, pushes it in
• don’t leave cotton wool in ear, prevents removal of debris
• otitis externa = avoid irritants by using ear plugs or cotton wool coated in white soft paraffin when showering, or shower cap, clean after swimming
• ensure ear plugs, ear phones etc cleaned regularly

Question 13

How many drops generally to put in - ears, eyes, nose?

Answer 13

Ears - 3+ drops
Eyes - 1 drop
nose - 2-3 drops