Hi everyone, i am a new grad RN currently working at a medical centre. Last week, i have a patient came for ear syringing procedure. i did the procedure as usual, but could not able to remove the wax. The patient insisted me to keep on doing the procedure for a while, as he really want to remove the things in his ear. When i observed his ear canal after the procedure, i clearly saw something moving.
I checked it few time, and still saw something moving, looked like some thing try to get the air after being drowned by the procedure. I was so confused and creepy at the same time, so i called the doctor to check.
However, he told me that actually what i saw is just the perforated tymphanic membrance.
I was soo soo scared and confused.
The patient stated he did not feel pain, just a bit uncomfortable during the procedure, no bleeding, and his hearing was totally normal. He also said he sometimes feel like something alive inside his ear. And the procedure was like usual.
May i ask if there is any change that his TM was perforated by me? If so, why his hearing is still normal and he didnt feel any pain at all? Is there any way to define a broken TM, and any way to reduce the risk of TM damage during ear syringing procedure? Pls help me!
Any advice will be much appreciated. thank you
Aug 10, '17
Were his ears examined by either you or the physician immediately prior to the ear wash procedure? That would answer the question of whether the rupture occurred during the procedure.
Aug 10, '17
I wouldn't assume that you caused the perforation, at all. It's possible but it may have been more likely to have caused brief sharp pain that would've been recognized during the procedure. It's also very possible that it was already perforated and/or he has chronic perforation - which may not cause acute pain in the setting of no infection. No way to tell since the tympanic membrane can't be visualized when the ear canal is packed full of wax. Personally, if I were using careful and accepted technique according to the facility's policies/procedures, I wouldn't entertain insinuations about it.