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according to NMC guidelines6 including information about consent, that there were no contraindications, what was seen (i.e. soft wax), what was done (i.e. irrigation - successful or otherwise) and that dry mopping was performed under direct light. Document what was seen after the procedure as well. If the procedure was successful it is important to note that the TM was seen and intact with normal features. Finally document the advice that was given to the patient. Dispose of equipment in line with local policy and decontaminate


the irrigator according the manufacturer’s guidelines or as advised by the Rotherham Primary Ear Care Centre guidance document.7


CONCLUSION Ear irrigation is a safe procedure when the nurse is properly trained and up-to-date with current guidelines. It can provide instant relief for the patient whose hearing is compromised by a build up of wax. It should however, always be a last resort, as irrigating the ear can predispose to infection. Education of patients as to the cause of wax accumulation and ear problems is essential to reduce the need for further irrigation.


REFERENCES 1. Price J. Problems of ear syringing. Practice Nurse 1997;14(2):126-8. 2. Mills L. Irrigating ears safely. Practice Nurse 2007;33(4):42-47. 3. Department of Health. Decontamination of Reusable Medical Devices in the Primary, Secondary and Tertiary care sectors (NHS and Independent Providers): 2007 Clarification and Policy Summary. London: DH; 2007.


4. Kalcioglu M, Tayyar M, Durmaz R et al. Does cerumen have a risk for transmission of hepatitis b? Laryngoscope 2004;114(3):577-80.


5. Rodgers R. How safe is your syringing? Community Nurse 2000;3(5):28-29.


6. Nursing and Midwifery Council. Record Keeping: Guidance for nurses and midwives. London: NMC; 2009. Available at: www.nmc-uk.org/ Publications/Guidance


7. Rotherham Primary Ear Care Centre. Cleaning Guidelines. Rotherham: RPECC; 2008. Available at: www.earcarecentre.com/cleaning.htm


8. Rotherham Primary Ear Care Centre. Guidance Document in Ear Care. Rotherham: RPECC; 2008. Available at: www.earcarecentre.com/ protocols.htm


RESOURCES Rotherham Primary Ear Care Centre www.earcarecentre.com Ear Irrigation Courses www.healthtrain.co.uk


Excellence in Ear Care


Sets the standard in ear irrigation PROPULSE®


NG Ear Irrigator


Ear wax removal scoop BOX 2. EQUIPMENT


Disposable gloves. Headlight. Otoscope with disposable speculae. Electronic irrigator with disposable jet tips. Water at 37°C. Noots tank (preferably disposable or otherwise lined with a plastic bag). Jobson Horne probe (preferably disposable). Cotton wool. Tissues. Waterproof cape (preferably disposable).


See these products in action at www.earcarevideo.com Available from your


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BioPark Hertfordshire, Broadwater Road, Welwyn Garden City, Hertfordshire. AL7 3AX UK


Tel: 0845 130 5440 www.miragehealthgroup.com


Fax: 0845 130 6440 76 Nursing in Practice March/April 2012


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