Paediatrics - Queensland Health - Queensland Government

Ear problems
Schedule 4
Flumethasone 0.02% + clioquinol
1%
DTP
IHW / SM R&IP / IPAP
Authorised Indigenous Health Workers and Isolated Practice Area Paramedic must consult MO / NP
Scheduled Medicines Rural & Isolated Practice Registered Nurses may proceed
Form Strength
Route of
administration
Recommended
dosage
Duration
Ear drops As above Topical - ear wick Soaked gauze
Provide Consumer Medicine Information
Management of associated emergency: consult MO
Administration tip - earwick
• Remove the wick using forceps. Inspect and clean the ear. Reinsert if required
• or
The wick is left in the canal
for 2 days then review
Schedule 4
Triamcinolone compound
(Kenacomb®)
DTP
IHW / SM R&IP / IPAP
Authorised Indigenous Health Workers and Isolated Practice Area Paramedic must consult MO / NP
Scheduled Medicines Rural & Isolated Practice Registered Nurses may proceed
Form Strength
Triamcinolone 0.1 %
Route of
administration
Recommended
dosage
Duration
Ointment
Neomycin 0.25 %
Gramicidino 0.025 %
Nystatin 100,000
units / g
Topical - ear wick
Ointment
soaked gauze
The wick is left in the canal
for 2 days then review
Provide Consumer Medicine Information
Management of associated emergency: consult MO
Administration tip - earwick
• Remove the wick using forceps. Inspect and clean the ear. Reinsert if required
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5. Follow up
Review in 2 days and in 1 week
Advise not to swim and keep ears dry until healed
Next MO visit if ear canal not back to normal at 1 week, or if recurrent
6. Referral / consultation
Otitis externa can become chronic or recurrent, especially in hot humid climates
General prevention involves keeping the ear canal dry and protected by a lining
of wax. Use drying ear drops e.g. Aqua-ear® / Vosol®, after swimming and
showering will help prevent recurrence
Advise patient to keep foreign objects such as cotton buds out of their ears;
remove built-up wax, if necessary with e.g. Waxsol®
Patients with recurrent infections often have a chronic fungal infection present.
This infection may be seen with fungal hyphae looking like wet blotting paper or
dry like cotton wool or the infection may be suspected even if the canal looks
clean and normal but is itchy
Suction ear toilet followed by Sofradex ® or flumethasone 0.02% + clioquinol
1% or triamcinolone compound (Kenacomb®) ointment to prevent further acute
bacterial infection
Primary Clinical Care Manual 2011 Controlled copy V 1.0 599
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