ear irrigation

1.	Inspect condition of external auditory canal. Assess client’s level of comfort. If indicated , use otoscope to check condition of tympanic membrane
2.	Check physician  order for types of irrigating solution to order
3.	Prepare patient
4.	Wash hands
5.	Assist client to lying or sitting position with head  tilted towards affected ear (client may help to hold basin )
6.	Place towel over shoulder  just under ear and emesis basin
7.	Inspect ear canal for accumulation  of cerumen or debris . remove with cotton applicator
8.	Check the irrigating solution for proper  temperature  of the solution for proper temperature by allowing small amount To run over inner aspect of forearm .The temperature of solution should be between 37 degree celcius to 38 degree Celsius  when it enters  the external canal
9.	Straighten auditory canal  for introduction of solution .in infants  pull auricle or pinna up and back
10.	With the tip of syringe  first above  canal opening  irrigate gently  by creating steady flow of solution against roof of auditory canal .if syringes  are used for ear irrigation , the size of syringe should be convenient to the operator
11.	Continue  irrigation until all debris has been removed or  all solution has been removed
12.	Assess client for onset of dizziness or nausea . onset of symptoms may require temporary cessation of procedure
13.	Dry off  external ear and apply cotton ball to auditory meatus
14.	Position client on side of affected ear for 10 minutes
15.	Remove equipment and wash hands
16.	Return to client to evaluate character and amount of drainage and determine clients level of comfort
17.	Record response to irrigation and note type , temperature and volume of solution used and character of drainage
18.	Return to client after 10 minutes to remove cotton ball and evaluate drainage client may return to normal level of activity