EAR - OSCE OTC Material OSPAP MSc PDF

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OSCE OTC Material OSPAP MSc...

Description

EAR CONDITIONS Condition Ear wax impaction (if still present after 5 days see doctor)

Symptoms   

Gradual hearing loss Ear discomfort Recent attempts to clean ear (common cause)

Other questions that can be asked include  Associated symptoms (dizziness)  Use of medicines (if patients have used otc medicine correctly then this would need referral)  Have they previously tried to clean ear

Treatment

Non-pharmacological

Cerumenolytics (wax softener) 1. Oil-based products – olive oil, arachis oil Plug a cotton wool to retain the liquid

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2. Peroxide-bases products- Earex advanced, Don’t plug a cotton wool but keep the head tilted to retain Warn patient might experience temporary bubbling sensation Wipe away any excess prevent irritation 3. Docusate 4. Sodium bicarbonate 5. Glycerine No drug interactions

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Peanut allergy should be warned preparations that contains arachis or almond oil Patients should be educated on administrations of this ear drops Advice patient to stop using cotton bud to clean ear as it will only push wax inside

Referral + other notes    

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Dizziness or tinnitus Pain originating from middle ear (infection?) Fever & malaise in children Associated trauma related deafness – this includes if you have tried to clean ear with a pin/ cotton bud anything Foreign body in ear- children most likely Otc medication failure- if tried OTC always check how they used it

EAR CONDITIONS Otitis externa

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Caused by excessive moisture to ear this changes microflora of ear canal

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Itching/irritation- main symptom Pain- main symptom Discharge that is not Mucopurulent (pus)

1. Choline salicylate  2. Acetic acid (Ear calm spray) If symptoms don’t improve within 48 hrs or worsen see GP

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 No drug interactions

Using a hair dryer (at the lowest heat setting) to dry the ear canal after hair washing, bathing, or swimming. Keeping shampoo, soap, and water out of the ear when bathing and showering.

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inflammation of pinna- outside visible part of ear Impaired hearing in children not associated with wax- glue ear Mucopurulent discharge + Systemically unwell -common in otitis media Slow growing growths on the pinna in elderly

Pain can be treated with otc analgesic such as paracetamol or ibuprofen Acute otitis media

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Ear ache- throbbing pain Ear discharge- main symptom Ear appears red/yellow

Analgesia Ibuprofen or paracetamol Should resolve in 3 days

Normally resolves within 72hrs

Refer    

Systemically unwell (fever and loss appetite) Under 2 years and have discharge Doesn’t improve in 3 days Reoccurring – glue ear

EAR CONDITIONS

EAR CONDITIONS...