Ear health check
The third part of the TAP Ear health screen is an ear health check.
It is important to check a person’s ear is healthy before completing a hearing test to assess if a person could benefit from hearing assistive products.
Check outside of ear
Instruction
Check: Do both ears look healthy?
Start by looking closely at the outside of the person’s ear using the light of the otoscope.
Look at the front and back of their pinna on each side. Check for:
- Signs of injury or infection
- Presence of ear canal.
Question
Look at this person’s pinna.
1. What action would you take after looking at their ear?
Select one.
Stop the ear health screen. This person’s ear does not have an ear canal. They have more complex needs. With their permission refer to a local ear and hearing professional.
2. What would you do if you see signs of an injured or infected pinna?
Select one.
Stop the ear health screen. This person’s ear is not healthy. With their permission refer to a local ear and hearing professional for treatment. Ask them to return for an ear health screen after treatment.
Check inside of ear
Look closely inside each ear with an otoscope.
Instruction
Check for:
- Ear discharge or infection
- Ear blocked with ear wax
- Foreign body in the ear
- Hole/s in eardrum.
Ear discharge (blood, pus, fluid)
If there is any discharge, mop it up before using the otoscope.
- If the person’s ear canal and eardrum look healthy, continue with the screen.
- If the person’s ear canal and eardrum are not healthy, with their permission, refer to ear and hearing professional for treatment. Ask them to return for an ear health screen after they have received treatment.
Question
Meet Ben
Ben is 64 years old. He enjoys meeting his friends for coffee. Recently Ben had a bad cold and a fever. He is now experiencing pain and discharge in his left ear.
You explain to Ben that you would like to check inside his ear.
1. What would you do first?
Select one.
Dry mop his ear is correct!
Ben has ear discharge. It is important to dry mop the discharge before looking inside his ear with an otoscope.
Look at the picture of what you see through the otoscope when looking inside Ben’s left ear.
2. Does the inside of Ben’s left ear look healthy?
Select one.
No is correct!
Ben’s left ear does not look healthy. The eardrum is red and bulging.
It is important to also check Ben’s right ear.
3. What action would you recommend to Ben?
Select two.
If you selected a and d you are correct!
Ben would benefit from treatment for his ear infection. After treatment, Ben should come for a repeat ear health screen to check his ear is healthy.
b and c are incorrect!
Both ears should be healthy to proceed with a hearing test to check if Ben would benefit from a hearing aid.
Ear blocked with ear wax
If you cannot fully see the eardrum, it may be because there is wax blocking the view of it.
If there is a lot of wax, remove it with a washout and continue with ear check.
If the wax is not removed by the washout, with the person’s permission refer to an ear and hearing professional.
Ear blocked with wax
Question
After removing ear wax what should you do next?
Select one.
If you selected b, you are correct!
It is important to check inside the person’s ear to see if the ear canal is clear and the eardrum is healthy. If their ear looks healthy, plan a hearing test.
a and c are incorrect.
Dry mopping is only done if the person has ear discharge.
Foreign body in the ear
If you see a foreign body in a person’s ear, remove it with an ear washout and continue with ear check.
If the object is still there after ear washout, with the person’s permission, refer to an ear and hearing professional.
Foreign body in ear canal
Hole/s in eardrum
If a person has a hole in their eardrum, they require referral to an ear and hearing professional.
Holes in eardrum
Question
If you have difficulty seeing the person’s eardrum, what could you do?
Select two.
If you selected a and c, you are correct!
The otoscope light and direction are important to see clearly inside the person’s ear.
b is incorrect.
An ear washout is not used to see the ear more clearly. It is used for removal of ear wax and foreign bodies.
Healthy/no ear problems
If both ears look healthy, explain to the person that you can plan to do a hearing test.
Activity
Look at the pictures of a person’s left and right ear and complete the ear check section of the screening form.
Left ear:
Right ear:
1. Do both ears look healthy?
Select one.
No is correct!
The left ear has signs of infection. The right ear is healthy.
2. What actions would you take?
Select two.
If you selected a and c, you are correct!
Refer the person to an ear and hearing professional and ask them to return for an ear health screen after treatment.
Question
1. Look at the picture of the inside of a person’s left ear. What do you see?
Select one.
If you selected e, you are correct!
The left ear is healthy – no ear problems.
2. Look at the picture of the inside of a person’s right ear. What do you see?
Select one.
If you selected b, you are correct!
The right ear canal is blocked with ear wax.
3. For this person, what action would you take?
Select one.
If you selected b, you are correct!
The person’s right ear is blocked with ear wax. Check it is safe to perform ear washout to remove ear wax. After removal check ear.
Activity
Gather equipment:
- Otoscope and different sizes of speculum
- Disinfectant and tissue to clean the speculum
- Two chairs.
Take turns to practice:
- Explain what you are going to do
- Check the outside of the person’s ear on each side
- Gently press the tragus to check for pain before checking the inside of the person’s ear on each side.
Reflection
- Were you able to see inside the person’s ear?
- Did you find any signs of ear health problems?