Ear Irrigation
Irrigating the ear involves washing the external auditory canal with a stream of solution to clean the canal of discharges, soften and remove impacted cerumen, or dislodge a foreign body. Sometimes, irrigation aims to relieve localized inflammation and discomfort. The procedure must be performed carefully so that it doesn’t cause discomfort or vertigo, or increase the risk of otitis externa. Because irrigation may contaminate the middle ear if the tympanic membrane is ruptured, an otoscopic examination always precedes ear irrigation.
Nursing Alert
This procedure is contraindicated when a vegetable (such as a pea) obstructs the auditory canal because this type of foreign body attracts and absorbs moisture. In contact with an irrigant or other solution, the foreign body swells, causing intense pain and complicating removal of the object by irrigation. Ear irrigation is also contraindicated if the patient has a cold, a fever, an ear infection, or an injured or ruptured tympanic membrane. The presence of a battery (or a battery part) in the ear contraindicates irrigation because battery acid could
leak, and irrigation would spread caustic material throughout the canal.
leak, and irrigation would spread caustic material throughout the canal.
Equipment
Ear irrigation syringe (rubber bulb) ▪ otoscope with aural speculum ▪ prescribed irrigant ▪ large basin ▪ emesis basin ▪ gloves ▪ linen-saver pad and bath towel ▪ cotton balls or cotton-tipped applicators ▪ 4″ × 4″ gauze pad ▪ Optional: adjustable light (such as a gooseneck lamp).
Preparation of Equipment
Select the appropriate syringe, and obtain the prescribed irrigant. Put the container of irrigant into the large basin filled with hot water to warm the solution to body temperature: 98.6°F (37°C). Avoid extreme temperature changes because they can affect inner ear fluids, causing nausea and dizziness.
Test the temperature of the solution by sprinkling a few drops on your inner wrist. Inspect equipment for breaks or cracks.
Implementation
Verify the doctor’s order.
Confirm the patient’s identity using at least two patient identifiers according to your facility’s policy.4
Provide privacy and explain the procedure to the patient. Answer all questions to decrease anxiety and improve cooperation.
If you haven’t already done so, inspect the auditory canal that will be irrigated with an otoscope.
Help the patient to a sitting position and tilt his head slightly forward and toward the affected side to prevent the solution from running down his neck. If he can’t sit, have him lie on his back and tilt his head slightly forward and toward the affected ear.
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