Ear irrigation is used to treat earwax impaction or foreign objects in the ear canal. It involves flushing the ear canal with sterile water or saline to remove debris. Contraindications include a perforated eardrum, ear infection, or foreign objects that may swell with moisture. The procedure positions the patient and inserts a bulb syringe filled with warm sterile solution into the ear canal while visualizing for debris removal. Complications can include ear infection, vertigo, or temporary or permanent hearing loss if not performed carefully.

1. Ear Irrigation

2. INTRODUCTION
 Ear wax (cerumen) is a natural protective oily substance
which is produced in the outer third of the ear.
Its function is to remove small foreign particles, such as
dust, from the canal and lubricate the ear..
This is achieved by the ciliary hairs.
Under normal conditions, the body keeps the amount of
earwax in the ears under control.
Too much earwax or hardened earwax can cause a
blockage in the ear, resulting in earaches, ringing in the ears,
or temporary hearing loss.

4. DEFINITION
 An ear irrigation is the process of flushing the external ear
canal with sterile water or normal saline. It is used to treat who
complains of foreign body or cerumen (ear wax) impaction.

5. To clean the external ear of cerume or ear wax.
To remove the foreign bodies.
To cleanse the ear in case of purulent discharges
caused in the middle ear infection.
To cleanse the ear in case of purulent discharges
caused in the middleear
PURPOSE

6. CONTRAINDICATIONS
This procedure is contraindicated when the auditory canal
is obstructed by a vegetable or grain foreign body such as
pea, bean, or corn kernel. These absorb moisture, causing
them to swell.
This procedure is also contraindicated if the patient has a
cold, fever, ear infection or unknown injury or rupture of the
tympanic membrane.

7. SOLUTIONS USED IN EAR IRRIGATUION
Sodium
bicarbonate
solution 1%
Normal
saline
Boric
acid 2-
4% Hydrogen
peroxide
2%
Sterile
water

8. EQUIPMENT
Prescribed sterile irrigating solution.
Irrigation set (container and irrigating bulb syringe).
K-basin ( kidney tray )
Cotton tipped applicators.
Clean gloves.
Cotton balls.
Spot light and head mirror.
Sterile gauze piece.
Protective towel

9. PROCEDURE
NURSING ACTION RATIONALE
1) Confirm physician order, check
client identification and condition.
1) Reduce the harmful outcomes from
avoidable patient identification
errors.
2) Explain the procedure to the client. 2) Reduce anxiety and ensures
cooperation.
3) After explaining procedure tothe
patient, place in a position of
sitting or lying with head tilted
forward and toward affected ear.
3) Ear should be accessible and to
drain into basin.
4) Wash hands 4) Reduces risk of transmission of
microorganism.
PREPARATORY PHASE

10. PROCEDURE (cont… ..)
NURSING ACTION RATIONALE
5) Position protective towels. 5) Water often runs down neck onto
clothing.
PERFORMANCE PHASE
6) Use a cotton applicator to remove
any discharge on outer ear.
6) Prevents carrying discharge deeper
into canal.
7) Place basin close to the
patient’s
head and under the ear.
7) Provides a receptacle to receive
irrigating solution.
8) Test temperature of solution. It
should be comfortable to the inner ear
aspect of wrist area ( approximately
98.6°F [37°C] or body temperature.
8) Solution that are hot or cold are
most uncomfortable and may initiate a
feeling of dizziness.

11. PROCEDURE (cont… ..)
9) Ascertion whether impaction is due
to a foreign hydroscopic (absorbs
moisture) body before proceeding.
9) If water contacts such a substance,
it may cause it to swell and produce
intense pain.
10) Gently pull the outer ear upward
and backward (adult) or downward
and outward (child).
10) Straightens the ear canal.
11) Place tip of syringe or irrigating
catheter just inside canal ( no more
than 8mm).
11) Decreases direct force of
irrigation against eardrum possibility
of rupturing it.
12) Observe for signs of pain or
dizziness.
12) Discontinue treatment if they
occur.
13) If irrigating does not dislodge the
wax, instill several drops of prescribed
crumenolytic and repeat as directed.
14) Softens and loosens impaction;
may be effective in as little as 15
minutes.

13. PROCEDURE
14) Dry external ear.
15) Discard soiled equipment and 15) Large amount of brown cerumen
make the patient comfortable. may be returned in irrigation solution.
16) Patients should lie on irrigated
(affected) side for a few minutes after
procedure toallow any remaining
solution to drain out.
16) Narrow ear canals may drain
slowly; retained solution may be
uncomfortable and lead to infection.
17) Wash hands 17) Reduce the transmission of
microorganisms.
18) Document effectiveness of the
treatment, condition of the canal, and
tympanic membrane and date and
time of irrigation and also volume and
type solution and the appearance of
the return flow.
18) For further reference about
effectiveness of procedure and
patient’s condition.
FOLLOW- UP PHASE

14. Ear infection.
Perforated eardrum.
Vertigo (typically temporary)
Deafness which can be temporary or
permanent.
COMPLICATIONS

16. https://youtu.be/gu4RH35AqIk
https://youtu.be/JVktI_1N274
https://youtu.be/4NDW8lLYFpQ