Earache Nurse Management Guidelines
Red Flag Exclusion Criteria
Child at risk of significant harm
Suspected non-accidental injury
Unplanned repeat ED presentation
Child ≤ 2 years
Aboriginal or Torres Straight Islander Child - see the RCH otitis media guideline
Hearing loss
Discharge from ear
History of direct trauma (including blunt trauma) to ear
Vomiting
Dizziness
Persistent fever
History of workplace injury
- Yellow or Red Zones observations or additional criteria outlined in the NSW Health Standard Observation Charts
Management Principles
Provide analgesia as required according to pain scale. Refer to Pain (any cause) NMG
History of live insect in ear; gently instil olive oil or lignocaine 1% into affected ear which will result in reduced pain and discomfort and drowns the insect (see lignocaine 1% Standing Order for dose).
DO NOT attempt to syringe the ear or attempt to remove insect – refer to medical officer if further treatment is needed
Document assessment findings, interventions, investigations and outcomes
References / Further Resources
NSW Children’s Hospitals Network (2012) Earache Factsheet NSW Children’s Hospitals Network
ECI Patient Factsheet - Ear Infections in Adults
The Royal Children's Hospital Melbourne (2016) Acute Otitis Media Clinical Practice Guideline