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Ear emergencies

 

Ear emergencies include objects in the ear canal and ruptured eardrums.

Considerations

Children often put objects into their ears. These objects can be hard to remove. The ear canal is a tube of solid bone that is lined with thin, sensitive skin. Any object pressing against the skin can be very painful. In many cases, a health care provider will need to use special instruments to examine the ear and safely remove the object.

Causes

 

Pain, hearing loss, dizziness, ringing in the ear, and ruptured eardrums can be caused by:

  • Inserting cotton swabs, toothpicks, pins, pens, or other objects into the ear
  • Sudden changes in pressure, as from an explosion, blow to the head, flying, scuba diving, falling while water skiing, or being slapped on the head or ear
  • Loud sounds, such as a gun firing

 

Symptoms

 

Symptoms include:

  • Bleeding from the ear
  • Bruising or redness
  • Clear liquid coming out of the ear (brain fluid)
  • Dizziness
  • Earache
  • Loss of hearing
  • Nausea and vomiting
  • Noises in the ear
  • Sensations of an object in the ear
  • Swelling
  • Visible object in the ear

 

First Aid

 

Depending on the type of ear emergency, follow the steps below.

OBJECT IN THE EAR

Calm and reassure the person.

  1. If the object is sticking out and is easy to remove, gently remove it by hand or with tweezers. Then, get medical help to make sure the entire object has been removed.
  2. If you think a small object may be lodged inside the ear, but you cannot see it, DO NOT reach inside the ear canal with tweezers. You can do more harm than good.
  3. Try using gravity to get the object out by tilting the head to the affected side. DO NOT strike the person's head. Shake it gently in the direction of the ground to try to dislodge the object.
  4. If the object does not come out, get medical help.

INSECT IN THE EAR

DO NOT let the person put a finger in the ear. This may make the insect sting.

  1. Turn the person's head so that the affected side is up, and wait to see if the insect flies or crawls out.
  2. If this does not work, try pouring mineral oil, olive oil, or baby oil into the ear. For an adult, pull the ear lobe gently backward and upward as you pour the oil. For a child, pull the ear lobe backward and downward as you pour. The insect should suffocate and may float out in the oil. AVOID using oil to remove any object other than an insect, since oil can cause other types of foreign objects to swell.
  3. Even if an insect appears to come out, get medical attention. Small insect parts can irritate the sensitive skin of the ear canal.

RUPTURED EARDRUM

The person will have severe pain.

  1. Place sterile cotton gently in the outer ear canal to keep the inside of the ear clean.
  2. Get medical help.
  3. Do not put any liquid into the ear.

CUTS ON THE OUTER EAR

Apply direct pressure until the bleeding stops.

  1. Cover the injury with a sterile dressing shaped to the contour of the ear, and tape it loosely in place.
  2. Apply cold compresses over the dressing to reduce pain and swelling.
  3. If part of the ear has been cut off, keep the part. Get medical help right away.
  4. Place the part in a clean cloth and keep it on ice.

DRAINAGE FROM INSIDE THE EAR

Cover the outside of the ear with a sterile dressing shaped to the contour of the ear, and tape it loosely in place.

  1. Have the person lie down on the side with the affected ear down so that it can drain. However, DO NOT move the person if a neck or back injury is suspected.
  2. Get medical help right away.

 

Do Not

 

If someone has an ear emergency, remember the following:

  • DO NOT block any drainage coming from the ear.
  • DO NOT try to clean or wash the inside of the ear canal.
  • DO NOT put any liquid into the ear.
  • DO NOT attempt to remove the object by probing with a cotton swab, a pin, or any other tool. To do so will risk pushing the object farther into the ear and damaging the middle ear.
  • DO NOT reach inside the ear canal with tweezers.

 

When to Contact a Medical Professional

 

Some symptoms may mean you have had serious injury to your ear. See a provider if you have:

  • Pain in the ear
  • Ringing sounds
  • Dizziness (vertigo)
  • Hearing loss
  • Drainage or blood from the ear
  • Recent blow to your ear or head

 

Prevention

 

Follow these steps to prevent ear emergencies:

  • Never put anything in the ear canal without first talking to a provider.
  • Never hit the head to try to correct an ear problem.
  • Teach children not to put things in their ears.
  • Avoid cleaning the ear canals altogether.
  • After an ear injury, avoid nose blowing and getting water in the injured ear.
  • Treat ear infections right away.

If you tend to feel pain and pressure in your ears when flying:

  • Drink a lot of fluid before and during the flight.
  • Avoid the use of alcohol, caffeine, or tobacco on the day of the flight.
  • Chew gum, suck on hard candy, or yawn during take-off and landing.
  • Talk to your provider about taking a decongestant or using a nasal spray before you fly.

 

 

References

Byyny RL, Shockley LW. Scuba diving and dysbarism. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 143.

Thomas SH, Goodloe JM. Foreign bodies. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 60.

 
  • What to do when kids put things in their ears

    Animation

  •  

    What to do when kids put things in their ears - Animation

    For some reason kids are fascinated with their ears and will often put things in there - peas or beads or all kinds of different things. I'm Dr. Allen Greene and let's talk about how to get things out of the ear when they go in. If there is a pea or a bead or a small toy that's gone into the ear and you can see it there, then take a pair of tweezers, turn the head to the side, gently grasp it and pull it out. If you can't see it though and you suspect there is something in there, it's time for a trip to the doctor. They have the tools to see be able to see it and better tools for pulling it out. Now a couple special cases: What happens when a bug crawls into the ear? It does happen. Same thing applies. If you can see it, pull it out with tweezers. If you can't though, there is a trick you could use. If you turn the head to the side and put a few drops of baby oil in, often that will bother the bug enough that they'll come up to the surface where you can grab it with the tweezers. The other thing is kids will sometimes put a Q-tip down deep in the ear or even a pencil down deep in the ear digging around. And it's not a problem getting it out, but they scream in pain because something got hurt. They can rupture their eardrum with things they put in there. If there is pain when something goes into the ear, that's another time to take them to the doctor. Often it will heal well on its own, but it should definitely be checked.

  • Ruptured eardrum

    Ruptured eardrum - illustration

    A ruptured eardrum is a perforation of the thin membrane that separates the outer ear from the inner ear. Symptoms of a ruptured eardrum include severe pain, hearing loss, discharge from the ear, or ringing in the ear. A ruptured eardrum may be uncomfortable but will usually heal on its own within a couple of months.

    Ruptured eardrum

    illustration

  • External and internal ear

    External and internal ear - illustration

    The ear is a complicated organ controlling hearing and balance. When sounds waves reach the ear, they are translated into nerve impulses. These impulses then travel to the brain where they are interpreted by the brain as sound.

    External and internal ear

    illustration

  • Foreign object removal

    Foreign object removal - illustration

    Only use tweezers if you can see the lodged object. Then get medical help to make sure the entire object was removed.

    Foreign object removal

    illustration

  • Foreign object in ear

    Foreign object in ear - illustration

    Children often place objects into their ears that can get stuck in the ear canal. It is important to remove the object since infection is most likely to occur. In most cases, a doctor will need to use special instruments to examine the ear and safely remove the foreign object.

    Foreign object in ear

    illustration

  • What to do when kids put things in their ears

    Animation

  •  

    What to do when kids put things in their ears - Animation

    For some reason kids are fascinated with their ears and will often put things in there - peas or beads or all kinds of different things. I'm Dr. Allen Greene and let's talk about how to get things out of the ear when they go in. If there is a pea or a bead or a small toy that's gone into the ear and you can see it there, then take a pair of tweezers, turn the head to the side, gently grasp it and pull it out. If you can't see it though and you suspect there is something in there, it's time for a trip to the doctor. They have the tools to see be able to see it and better tools for pulling it out. Now a couple special cases: What happens when a bug crawls into the ear? It does happen. Same thing applies. If you can see it, pull it out with tweezers. If you can't though, there is a trick you could use. If you turn the head to the side and put a few drops of baby oil in, often that will bother the bug enough that they'll come up to the surface where you can grab it with the tweezers. The other thing is kids will sometimes put a Q-tip down deep in the ear or even a pencil down deep in the ear digging around. And it's not a problem getting it out, but they scream in pain because something got hurt. They can rupture their eardrum with things they put in there. If there is pain when something goes into the ear, that's another time to take them to the doctor. Often it will heal well on its own, but it should definitely be checked.

  • Ruptured eardrum

    Ruptured eardrum - illustration

    A ruptured eardrum is a perforation of the thin membrane that separates the outer ear from the inner ear. Symptoms of a ruptured eardrum include severe pain, hearing loss, discharge from the ear, or ringing in the ear. A ruptured eardrum may be uncomfortable but will usually heal on its own within a couple of months.

    Ruptured eardrum

    illustration

  • External and internal ear

    External and internal ear - illustration

    The ear is a complicated organ controlling hearing and balance. When sounds waves reach the ear, they are translated into nerve impulses. These impulses then travel to the brain where they are interpreted by the brain as sound.

    External and internal ear

    illustration

  • Foreign object removal

    Foreign object removal - illustration

    Only use tweezers if you can see the lodged object. Then get medical help to make sure the entire object was removed.

    Foreign object removal

    illustration

  • Foreign object in ear

    Foreign object in ear - illustration

    Children often place objects into their ears that can get stuck in the ear canal. It is important to remove the object since infection is most likely to occur. In most cases, a doctor will need to use special instruments to examine the ear and safely remove the foreign object.

    Foreign object in ear

    illustration

A Closer Look

 

    Talking to your MD

     

      Self Care

       

        Tests for Ear emergencies

         

           

          Review Date: 5/14/2016

          Reviewed By: Jesse Borke, MD, FACEP, FAAEM, Attending Physician at FDR Medical Services/Millard Fillmore Suburban Hospital, Buffalo, NY. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

          The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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