Ask your patient if the pressure is acceptable to them. For example, “Is the pressure I’m using ok, Mr. Neumaier? Let me know if you have any discomfort. ”
Your stabilizing hand acts a protecting lever if the person suddenly moves the head.
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. [5] X Trustworthy Source PubMed Central Journal archive from the U. S. National Institutes of Health Go to source
Adults: 4 to 6 millimeters Children: 3 to 4 millimeters Infants: as small as 2 millimeters
Avoid putting too much pressure on the otoscope, which can bump the inner canal wall, causing the patient discomfort.
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.
The ear canal should be the color of skin with tiny hairs. It may have some yellowish brown or reddish brown earwax, which is normal. There should be no swelling. The eardrum should be pearly white or grey and translucent. You should see tiny bones pushing on the eardrum and a cone of light visible at the 5 o’clock position in the right ear and the 7 o’clock position in the left
Wiggling or pulling on the outer ear causes pain or discomfort. The ear canal may also be red, tender, swollen or filled with pus. The eardrum may have little or no light reflection. You may also see redness bulging, visible amber liquid or bubbles behind the eardrum. There may also be visible hole(s), whitish scars on the surface of the eardrum, wax blockage, and blockage with an object such as a bean or bug.
Inflammation Redness Swelling Pus A dull or red eardrum Fluid or bubbles behind the eardrum A hole in the eardrum Foreign objects or impacted wax
