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Discussion

Syringing ears, a question

I just started working in a family practice office and one of my jobs is ear syringing. They have several big metal ear syringes. They are big, leaky, cumbersome and not air tight. (lots of bubbles) On top of that the tips are long and thin, really enormous and I'm terrified of perforating someone's eardrum.

I've used the electric syringe in the past as well as the 10cc toomey syringes without any problems and a lot of success. I know my bosses will not go out and buy new syringes, so I'm stuck using those awful things. Does anyone have an tips (short of refusing to do them) on how to SAFELY use those things? Right now I avoid going inside the ear canal and I'm not being very successful.

The very last thing I want is to hurt someone.

Laura

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Practice using one several times with no patient and learn how to avoid the problems you cite. If you still have problems, ask one of the docs to show you how to use it better. Nobody is born knowing how to use these instruments, and regardless of having used other kinds of tools in the past, there is a learning curve.

Of course when you have a live patient, you will use your finger to avoid jamming the tip in as far as the drum, just as you control how deeply you give a PPD, for example.

No advice, but you just made me think of my 5th grade teacher.

He gave us a hygeine lesson where he went on about hearing a kid screaming in the doctor's office because the kid didn't clean his ears and they had to put boiling water in them to clean 'em out! Of course I went home and dug Q tips in my ears until they bled...

Laura, Uhhggg! I haven't done a ear wash in a while but not missing it much. We used a few different methods. First of all, do they require you to use the metal syringe? If so, it is critical to steady your hand against the pt's head, When they move-you move. Always aim at the wall of the ear canal as not to push the debris further in and again if they move you will likely hit the side. We have also used other methods. My favorite, a 10cc syringe with a butterfly needle attached at the end (needle cut off of course! :eek:) the tubing was softer than the metal and able to clear tight spaces in a single squirt. We have also used a Water Pic, yea like on your teeth. It worked well but was messy and the noise sometimes scared the kids. Also, our Docs would have the pt take glycerin ear drops 3day to 30 min before the proceedure depending on the amount of debris. Always helped! For the kids I had them wear a fun tropical print gown and had a pair of those really big sunglasses they could put on as I set up the equipment and explained what was going to happen. We were all going to get wet anyway. Hope it helps :)

  • Experts

I do ear lavages daily - I use a disposable 60 cc Toomey syringe with a reusable metal tip. The tips are round althought I have seen a couple that do not have the rounded end, I presume for a smaller ear canal. The pt holds the cup, I lift the ear up with fingers of one hand and squirt with the other. It did take me a little to get the hang of manipulating the syringe because of the size. Man, if I could only use a 10cc on some of the ears these allergy-suffering, q-tip-jamming 18 year-olds bringin, I'd be there forever lol.

Frequently we will use a 10-15 minute mineral oil soak for the really impacted ones.

simple solutions, as I do them daily...

Use a 20 cc ( or 10cc) toomey, and an 18g (or 16g) jelco (without the needle!)...

And if you get nothing out, put 2 cc of LIQUID colace into the ear, and soak it for 10-15 min, and then do the lavage...

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