Paediatrics - Queensland Health - Queensland Government

Ear problems
Cleaning techniques for ears with chronic discharge
Suction
• Suction under direct vision is the most effective technique but this requires special
equipment and training
Dropper method
• The ear canal can be cleaned by irrigating with clean water using an eye dropper
• An eye dropper uses a small volume of wash solution at low pressure and is therefore
relatively safe in unskilled hands
• Eye droppers are cheap and easy to obtain and to clean for use at home
Equipment
• A clean eye dropper and bulb. This can be washed with soap and water or an antiseptic
• A clean container of clean water (sterile or cool boiled) (some rainwater tanks may be
contaminated)
• Clean container for the dirty water from the ear
Technique
1. The patient should be sitting or lying down with the affected ear upwards
2. Using a clean dropper filled with clean water, squirt water into the discharging ear.
Only the tip of the dropper needs to be in the canal. Without withdrawing the dropper
and just by releasing the bulb, suck the water and pus back into the dropper
3. Discard the contents of the dropper into the container for dirty water. Do not squirt the
water in and out of the ear. When all the pus has been washed out of the ear, the water
sucked back into the dropper is clear
4. Repeat the above steps until there is clean return from the ear
5. Dry the ear canal using tissue spears (see details)
Tissue spear method (dry mopping)
• This can safely be done by a child on their own or by the parent. It should be done
whenever the ear discharges. The tissue paper actively absorbs the moisture
• In the management of chronic suppurative otitis media, the tissue spear method should
be used in conjunction with regular eye dropper irrigation by the Health Care Worker
Technique
1. Make a spear by twisting corner of tissue paper
2. Insert into ear gently, twisting slowly
3. Stop when child blinks
4. Leave in place for 30 seconds then remove and repeat until tissue tip is dry
5. Perform at least twice per day until the ear is dry
Topical antibiotics and other ear drops with dry mopping
• The patient should be sitting or lying down with the affected ear upwards
• Clean and dry the ear canal as per dropper method and tissue spears
• Instil the ear drops
• Apply tragal pressure (pressing several times on the flap of skin in front of ear canal)
after the drops have been instilled to assist the drops through the perforation [1]
• Keep the patient in position for several minutes
• Use of cotton wool as a ‘plug’ just soaks up the medication. Let excess run out
594
Controlled copy V1.0
Primary Clinical Care Manual 2011