Ear emergencies
Definition
Ear emergencies include objects
in the ear canal and ruptured eardrums.
See also: Acoustic trauma
Considerations
Children often stick objects into
their ears. These objects can be difficult to remove because the
ear canal is a tube of solid bone that is lined with thin,
sensitive skin. Any object pressing against the skin can be very
painful. In many cases, a doctor will need to use special
instruments to examine the ear and safely remove the
object.
Causes
Pain, hearing loss, dizziness,
ringing in the ear, and ruptured
eardrums can be caused by:
- Inserting cotton swabs,
toothpicks, pins, pens, or other objects into the ear.
- Sudden changes in pressure, as
from an explosion, blow to the head, flying, scuba diving, falling
while water skiing, or being slapped on the head or
ear.
- Loud percussions, such as a gun
going off.
Symptoms
First Aid
Follow the steps below, depending
on the type of ear emergency.
OBJECT IN THE EAR
- Calm and reassure the
person.
- If the object is sticking out
and easy to remove, gently remove it by hand or with tweezers.
Then, get medical help to make sure the entire object was
removed.
- If you think a small object may
be lodged within the ear, but you cannot see it, DO NOT reach
inside the ear canal with tweezers. You can do more harm than
good.
- Try using gravity to get the
object out by tilting the head to the affected side. DO NOT strike
the person's head. Shake it gently in the direction of the ground
to try to dislodge the object.
- If the object doesn't come out,
get medical help.
INSECT IN THE EAR
- DO NOT let the person put a
finger in the ear, since this may make the insect
sting.
- Turn the person's head so that
the affected side is up, and wait to see if the insect flies or
crawls out.
- If this doesn't work, try
pouring mineral oil, olive oil, or baby oil into the ear. As you
pour the oil, pull the ear lobe gently backward and upward for an
adult, or backward and downward for a child. The insect should
suffocate and may float out in the oil. AVOID using oil to remove
any object other than an insect, since oil can cause other kinds of
objects to swell.
- Even if an insect appears to
come out, get medical attention. Small insect parts can irritate
the sensitive skin of the ear canal.
RUPTURED EARDRUM
- The person will have severe
pain. Place sterile cotton gently in the outer ear canal to keep
the inside of the ear clean.
- Get medical help.
CUTS ON THE OUTER EAR
- Apply direct pressure until the
bleeding stops.
- Cover the injury with a sterile
dressing shaped to the contour of the ear, and tape it loosely in
place.
- Apply cold compresses over the
dressing to reduce pain and swelling.
- If part of the ear has been cut
off, keep the part. Get medical help immediately.
- Place the part in a clean cloth
and keep it on ice.
DRAINAGE FROM INSIDE THE
EAR
- Cover the outside of the ear
with a sterile dressing shaped to the contour of the ear, and tape
it loosely in place.
- Have the person lie down on the
side with the affected ear down so that it can drain. However, DO
NOT move the person if a neck or back injury is
suspected.
- Get medical help
immediately.
DO NOT
- DO NOT block any drainage coming
from the ear.
- DO NOT try to clean or wash the
inside of the ear canal.
- DO NOT attempt to remove the
object by probing with a cotton swab, pin, or any other tool. To do
so will risk pushing the object farther into the ear and damaging
the middle ear.
- DO NOT reach inside the ear
canal with tweezers.
When to Contact a Medical Professional
The following symptoms, which may
indicate significant trauma to the ear, should be evaluated by a
physician:
- Pain in the ear
- Ringing sounds
- Dizziness
(vertigo)
- Hearing loss
- Drainage or blood from the
ear
- Recent blow to your ear or
head
Prevention
- Never put anything in the ear
canal without first consulting a physician.
- Never thump the head to try to
correct an ear problem.
- Teach children not to put things
in their ears.
- Avoid cleaning the ear canals
altogether.
- Following an ear injury, avoid
nose blowing and getting water in the injured ear.
- Treat ear infections
promptly.
If you tend to feel pain and
pressure when flying, drink lots of fluid before and during the
flight. Avoid the use of alcohol, caffeine, or tobacco on the day
of the flight. Chew gum, suck on a hard candy, or yawn during
take-off and landing. Talk to your doctor about taking a
decongestant or using a nasal spray before you fly.
References
Auerbach PS. Wilderness
Medicine. 4th ed. St. Louis, Mo: Mosby;
2001:468-470.
DeLee JC, Drez, Jr., D, Miller
MD, eds. DeLee and Drez’s Orthopaedic Sports Medicine. 2nd
ed. Philadelphia, Pa: Saunders; 2003:758.
DiMuzio J Jr, Deschler DG.
Emergency department management of foreign bodies of the external
ear canal in children. Otol Neurotol. 2002
Jul;23(4):473-5.
Review Date: 10/10/2008
Reviewed By: Alan Lipkin, MD, Otolaryngologist, Private Practice,
Denver, Colorado. Review provided by VeriMed Healthcare Network.
Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M.,
Inc.
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