This exam can be used in pre-teaching and post-teaching sessions as a learning tool as well as an evaluation instrument.
General Examination
- Discussed the need for otoscopic assessment
- Described the possible need to remove cerumen to view ear
- Described positioning and the possible need for secure holding method
Equipment:
- Selected appropriate size ear speculum for proper seal and comfort to patient, given child’s age/size Age___ Size___
Positioning:
- Ensured appropriate position (including caregiver assisted) for patient based on age and/or developmental status of patient.
- If needed, assured that child’s head was appropriately secured
- If not able to perform step 6, asked for assistance from caregiver
Distraction Techniques:
- Used distraction techniques appropriate for age/development stage.
Otoscopic Examination:
- Inserted otoscope with dominant hand.
- Stabilized otoscope either by one-handed or two-handed method
- Manipulated auricle to facilitate view of TM
- Stabilized otoscope by bracing finger/dorsum of hand on infant/child’s face or head
Cerumen Removal
- Identified need for cerumen removal
- Asked appropriately for assistance
- Secured and/or distracts child prior to removal attempt
- Stabilized head
- Used scope appropriately to aid in removal of cerumen
- Used appropriate instrument for removal
- Able to remove some cerumen but inadequate for appropriate TM visualization
- removed via direct visualization via open-headed otoscope
- removed via indirect visualization
- Appropriately identified that cerumen removal was inadequate for TM visualization
- Able to remove adequate cerumen for appropriate visualization of TM
- removed via direct visualization
- removed via indirect visualization
Pneumatic Otoscopy
- Appropriately attaches insufflators to otoscope
- Uses appropriate speculum size: Age_____ Size____
- Checks for airtight seal
- Use insufflator with patient appropriately