# Ear Irrigation

## Overview

This module describes how to irrigate the ear to remove cerumen or foreign bodies.

## Indications

## Contraindications

## Patient information and consent

Always verify your patient’s identity and obtain informed consent before proceeding.

### How do I explain this procedure?

“When I examined your ear, I saw a buildup of earwax or an object that needs removal.”

### What can my patient expect?

“I will first put some drops in your ear and ask you to lie down. After a while, I’ll wash out your ear with a syringe and some water. This only takes 15 minutes.”

### What is my patient’s role?

“Tell me if you have any allergies or medical conditions. Let me know if you have pain or dizziness while I wash out your ear.”

## Preparation

Prepare a trolley with equipment. Have a good light source.

### Documentation

### Equipment

## Site & Positioning

Position the patient sitting upright, sideways in front of you with the ear to be syringed pointing towards the source of light. Syringing should be done in good light so that you can see where you are placing the tip of the syringe. A child should be seated on an adult’s lap with both the head and the body firmly held.

## Procedure

Follow medical asepsis without gloves.

## Troubleshooting

My patient is unable to follow instructions.

These patients may need procedural sedation. Discuss this with a senior colleague before attempting.

I’ve tried everything, but I can’t get the cerumen out. It is hard and impacted.

Remember that wax dissolves in water, so if cerumenolytic drops are unavailable, lie the patient down with the wax filled ear uppermost and fill the ear canal with water. Ask the patient to pump the tragus—refilling the canal a few times—and then try syringing again. Repeat this again if necessary. If still unsuccessful, ask the patient to fill their ear with water and pump the tragus a few times during the rest of the day, returning the next day for another attempt. If unsuccessful, instrumental cerumen removal may be indicated. Ask a senior colleague for assistance, or refer to otolaryngology.

The syringe plunger does not move smoothly up and down.

Try a different syringe or a larger 50 ml syringe. If unsuccessful, use a metal syringe if one is available.

I have scratched my patient’s ear canal with the tip of the cannula.

Explain to the patient what has happened and put some ear drops in it. Explain that they should return if the ear becomes sore or begins to discharge.

My patient has a living bug in their ear.

First, drown it using a few drops of oil. Then remove it using the method above.

## Risks

## References