EAR CARE PROCEDURE FOR COMMUNITY NURSING SERVICES

AURAL NURSING RISK ASSESSMENT RECORD
Patients Full Name:
DOB:
NHS Number:-
Left Ear Right Ear
YES NO YES NO
History of tympanic perforation
Cleft Palate
Unable to give valid consent
Recent history of otalgia (ear ache) or
middle ear infection [in previous six weeks]
Does the patient have history of hearing loss that
is not related to the excess production of wax
Does the patient have hearing in only one ear
[NB such patients should not have that ear
irrigated as the risk of damage (although minimal)
is unacceptable - refer to GP]
Have there been any significant problems
previously with ear irrigation e.g pain /
perforation / vertigo after procedure / other
Please state:
Mucoid / discharge other than waxy discharge
Is there a recent history of Giddiness, nausea,
vertigo or Ear surgery e.g. mastoid
NB NEVER IRRIGATE A MASTOID CAVITY
Tinnitus or menieres disease
Is patient currently taking anticoagulants
CLINICAL ASSESSMENT
Check for signs for foreign bodies e.g. grommets,
inflammation / discharge, offensive discharge
Otitis media / externa (usually found in both ears)
Left Ear Right Ear
Yes No Yes No
Pain in or about ear when moving pinna Please
state:
Swelling in or around the ear
Evidence of impacted wax
Hearing Aid
Non concordance to treatment /no valid consent
DO NOT IRRIGATE EAR/S IF THE ANSWER IS YES TO ANY OF THE ABOVE –
REFER PATIENT TO MEDICAL PRACTITIONER
EAR CARE PROCEDURE
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