HHC Health & Home Care Clinical Policy And

HHC HEALTH & HOME CARE SECTION: 1-1
Ear Irrigation __RN
PURPOSE: 5. Position protective covering under the patient's
affected ear.
To remove impacted cerumen, discharge or a foreign
body from auditory canal to improve impaired hearing
caused by earwax.
CONSIDERATIONS:
1. Procedure requires a physician order. Clarify all
physicians’ orders if unapproved abbreviations are
6. Fill syringe with prescribed irrigating solution.
Position basin / bowl directly under the patient's ear.
Gently pull ear upward and backward for adult or
downward and back for a child (under age 3) to
open ear canal before irrigating. Gently insert
syringe tip into external auditory canal.
used. 7. Instill irrigant gently but steadily into sides of ear
2. Use at least two (2) patient identifiers prior to
administering medications.
3. Do not irrigate without consulting physician if:
foreign body or discharge is present, patient has
history of perforation or complications from a
previous ear irrigation, patient has a cold, fever or
ear infection or ruptured membrane.
4. Procedure may need to be discontinued if dizziness,
nausea or extreme discomfort occurs.
5. If irrigation is unsuccessful, the physician may order
instillation of 2-3 gtts of glycerin, carbamide
peroxide or similar preparation 2-3 times a day for
2-3 days.
EQUIPMENT:
Otoscope with aural speculum is suggested to view the
ear canal before and after and at any time during the
procedure.
canal. Do not occlude ear canal with irrigating
device. Allow fluid to drain out during installation.
Continue irrigation until impacted cerumen or
foreign body is expelled and/or irrigant is clear. No
more than 500 cc of irrigant is to be used during this
procedure.
8. Immediately stop the treatment and notify physician
if the patient complains of discomfort.
9. Discard soiled supplies in appropriate containers.
AFTER CARE:
1. Cleanse equipment and area.
2. Document in patient's record:
a. Date and time of irrigation procedure.
b. Amount and type of irrigation solution.
c. Note ear irrigated.
d. Describe appearance of return flow of irrigant.
e. Describe appearance of ear canal before and
after irrigation.
Clean eyedropper f. Patient’s response to procedure and any
Soft or small bulb syringe
comments patient made on condition, especially
Medication or prescribed irrigation solution
related to hearing acuity.
Cotton ball or cotton tipped applicators
Large basin/bowl
3. Instruct patient in proper ear hygiene and care. (Do
not insert applicators or pointed objects in ears. Do
not hit the side of the head in an attempt to dislodge
Towels or protective cover
Clean container for irrigating solution
wax or foreign bodies, etc.)
Personal protective equipment as indicated
Optional: adjustable light
PROCEDURE:
1. Adhere to Universal Precautions.
2. Explain the procedure to the patient. Explain that
he/she may experience pressure in the ear and/or
dizziness.
3. Inspect auditory canal with otoscope if available.
4. Assist patient to sitting or supine position, tilt head
slightly forward and toward affected side. If patient
is unable to sit, assist him/her to lie on back and tilt
head slightly to the side and forward toward affected
ear.
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