Views:36 Author:SunnyWorld Publish Time: 2018-09-21 Origin:Site
The Physician uses a specialized instrument called an “otoscope” (“oto” = Ear; and “scope” = to view) to examine an ear. The otoscope allows the physician to not only magnify the small areas of the ear but it also provides light for the areas that are to be viewed. Even though the otoscope is traditionally a tool of a physician, one does not have to be a physician to be able to use this instrument. However, it must be emphasized that you cannot simply “pick up” an otoscope or any other technical instrument and use it beneficially. The correct use of such an instrument requires, at least, some basic instruction in its use and function.
★ Getting Yourself and Your Patient Ready
◆ Handle the otoscope properly. Turn the otoscope’s light on and hold your otoscope “upside down” between your thumb and pointer finger like a pen or pencil. Place the back of your hand along the person’s cheek so that otoscope is steady and braced. While the position may feel awkward at first, it soon will feel natural. Use your dominant hand to examine both ears.Your stabilizing hand acts a protecting lever if the person suddenly moves the head.
◆ Straighten the ear canal. Use your opposite hand to gently pull the outer ear up and back on patients older than 12 months. Straightening your patient’s ear canal can make it easier to examine the ears.Pull the outer ear down for babies and children younger than 3 years old.Grasp the ear at the 10 o’clock position when examining the right ear and the 2 o’clock position for the left.
◆ Be gentle with the patient. The ear is a very sensitive organ and can injure easily if improperly examined. Avoid pulling, pushing, or generally being rough with the patient you are examining. This can calm your patient and minimize the risk of injury from sudden movements.
★ Examining The Ear
◆ Choose the right speculum size. Put a new speculum, or pointed end, onto your otoscope before each patient. Select the largest possible speculum that your patient’s ear will accommodate. When inserted, the speculum should fit snugly into the outer third of the ear canal. Speculums that are too small can cause discomfort and reduce how much of the ear you can examine. Use the following guidelines for speculum size:
Adults: 4 to 6 millimeters
Children: 3 to 4 millimeters
Infants: as small as 2 millimeters
◆ Examine the external ear first. Without using the otoscope, take a look at the person’s external ear and notice any redness, discharge or swelling. Manipulate the ear gently and ask the patient if there is any pain. With Swimmer’s ear there is often pain, swelling, redness, and discharge that can be observed before even using the otoscope.
◆ Insert the otoscope slowly into the ear canal. Place the otoscope at your patients ear, not in it. Look into your otoscope and then slowly insert the pointed end of it into the ear canal. Steady your hand on the side of the individuals face if necessary. Slow and gentle insertion can prevent unwanted movement in your patient. It also keeps your hand and scope in line with the ear and minimizes the risk of injury.Avoid putting too much pressure on the otoscope, which can bump the inner canal wall, causing the patient discomfort.
◆ Push the speculum 1 to 2 centimeters into the canal. Avoid ramming the speculum into the ear canal. Insert it at most 1 to 2 centimeters and then use the light to view beyond the tip of the speculum. Stop the examination immediately if the patient expresses any pain or discomfort. Examine the middle ear and eardrum.
◆ Angle the otoscope. Angle the tip of the otoscope towards the person’s nose. This follows the normal angle of the ear canal. From here, move the otoscope gently at different angles. This allows you to view the person’s eardrum and canal walls. Stop the exam at any sign of increased pain or discomfort.
◆ Remove the otoscope. Return the otoscope back to your starting position. As you watch through the speculum, gentle take the speculum and scope out of the person’s ear canal and outer ear. Release the person’s ear from your grasp.
◆ Throw away the speculum. Remove the speculum from the otoscope. Throw it away in a certified medical waste container to minimize the spread of disease or infection to other patients.If you don’t have disposable speculums, scrub each tip with hot water to remove excess wax. Then soak the speculum in a covered dish of rubbing alcohol for 10 minutes.