Performing Ear irrigation

Definition:
An ear irrigation is washing of the external auditory canal with stream of liquid.

Purposes:
1. To remove the ear wax.
2. To remove the foreign bodies (except hygroscopic substances)
3. To cleanse the ear in the case purulent discharge caused by the middle ear infection.
4. For antiseptic effect
5. To apply heat.
6. To evaluate vestibular functions.

Solution used:
1. Boric acid 2-4%
2. Sodium bicarbonate solution 1%
3. Normal Saline.
4. Hydrogen peroxide.
5. Sterile water.

Articles:
1. Prescribed sterile irrigating solution (warmed to 37 degree centigrade)
2. Irrigation set. (Container and irrigating bulb syringe)
3. Waterproof pad.
4. Emesis basin.
5. Cotton tipped
6. Clean gloves
7. Cotton balls.
8. Spot light and head mirror
9. Sterile gauze piece.
10. Sterile jug with extra fluid.
Procedure:

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Nursing Interventions Rationale
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1.  Explanation facilitates cooperation and
 Explain the procedure to the client.
provides reassurance for the patient.
2.  Assemble the equipment. Protect the
 This provides for an organized
client and bed linens with a moisture
approach to the task.
proof pad.
3.  Handwashing deters the spread of
 Wash your hands.
microorganisms.
4.  Have the client sit up or lie with the
head tilted toward the side of the
 Gravity causes the irrigating solution to
affected ear. Have the client support a
flow from the ear to the basin.
basin under the ear to receive the
irrigating solution.
5.  Clean the pinna and the meatus at the
auditory canal as necessary with  Materials lodged on the pinna and the
the normal saline or the irrigating meatus may be wahed into the ear.
solution.
6.  Fill the bulb syringe with solution. If
 Air forced into the ear canal is noisy
an irrigating container is used, allow
and therefore unpleasant for the client.
air to escape from the tubing.
7.  Straightening the auditory canal by  Straightening the ear canal aids in
pulling the pinna down and back for an allowing solution to reach all areas of
infant and up and back for an adult the ears easily.
8..  Direct a steady, slow stream of
solution against the roof of the  Solution directed at the roof of the
auditory canal, using only sufficient canal aids in preventing injury to the
force to remove secretions. Do not tympanic membrane. Continuous in-
occlude the auditory canal with the and-out flow of the irrigating solution
irrigating nozzle. Allow solution to helps prevent pressure in the canal.
flow out unimpeded.
9.  When the irrigation is completed,
place a cotton ball loosely in the  The cotton ball absorbs excess fluid.
auditory meatus and have the client lie Gravity allows the remaining solution
on the side of the affected ear on a in the canal to escape from the ear.
towel or an absorbent pad.
10. Discard the irrigated fluid and swabs.
Clean and replace reuseable articles.
11. Wash hands Prevents spread of microorganism
12. Record the irrigation, appearance of Acts as communication between staff
 the drainage and the patient’s
response.
13. Remove the cotton ball and assess
drainage after 15 minutes.
nurses.
Drainage or pain may indicate injury to
the tympanic membrane.