| Subject | Contents |
| Definition | An ear emergency is any injury to the outer, middle, or inner ear. It can also be an object in the ear. |
| Alternative Names | Foreign body lodged in the ear canal |
| Considerations | There are multiple causes of damage to the ear, many of them emergencies: Acoustic trauma : Loud percussions, such as a gun going off, can cause immediate hearing loss and ringing in the ear. If the percussion is close enough and loud enough, it can actually perforate the eardrum . Barotrauma: Rapid changes in pressure, especially in the presence of blocked eustachian tubes, can cause pain and occasional perforation of the eardrum. Pressure changes occur when flying, scuba diving, and driving in the mountains. A common cause of sudden pressure change and a frequent cause of perforated eardrums is waterskiing. Rapid pressure changes occur when the skier falls and hits the water. Being slapped or hit on the ear can also rupture the eardrum and cause hearing loss. There can also be dizziness and ringing in the ear (tinnitus) associated with hearing loss. Foreign bodies: Children often stick objects into their nose or ears (for unclear reasons). It is not an uncommon occurrence, with foreign bodies in the nose being more common than foreign bodies in the ear. These foreign bodies can be difficult to remove because the ear canal is basically a tube through solid bone that is lined with thin and very sensitive skin. Anything pressing against the skin, such as forceps attempting to grasp the foreign body, can cause excruciating pain. Infection: Middle ear infections are common in childhood. It causes pain and ruined nights for the child and the parents. Infections can result in temporary loss of hearing, ringing in the ears (tinnitis), and the persistence of fluid in the middle ear. Multiple repeat infections can result in scarring or thickening of the membranes in the middle ear with gradual loss of hearing. Any significant trauma to the ear should be evaluated by a physician. In children, the decision is often simple because the problem is usually associated with pain. Adults should seek attention if they have trauma that results in ringing (tinnitis), hearing loss, drainage from the ear, blood from the ear, pain or other problems that appear to result from trauma, or infection in the ear. Special instruments are needed to examine the ear thoroughly, and safely remove the foreign body. |
| Causes | The most common cause of a perforated eardrum is trauma, such as the deliberate or accidental insertion of an object like cotton swabs, bobby pins, or toothpicks. Sudden, excessive changes in pressure, such as an explosion, a blow to the head (ear), flying, scuba diving, falling while water skiing, etc. Earache, middle ear infection (otitis) . Anything inserted into the ear is considered a foreign body, even when inserted with good intent. Types of objects that get lodged in the ear include inserted objects, insects, or airborne objects. |
| Symptoms | BleedingBruisingDizzinessLoss of hearingNausea and vomitingNoises in the earEarache Redness Swelling Foreign object visible in the ear Sensations of a foreign object in the ear Clear liquid coming out of the ear (CSF-brain fluid) |
| First Aid | 1. If there is bleeding from cuts on the outer ear, apply direct pressure. If part of the ear has been cut off, keep the part and get medical help immediately. Cover the injured ear with a sterile dressing shaped to the contour of the ear, and tape it loosely in place. Apply cold compresses over the dressing to help reduce pain and swelling . 2. If there is drainage from inside the ear, cover the outside of the ear with a sterile dressing that conforms to the contour of the ear, and tape it loosely in place. Have the victim lie down on the side with the affected ear down so that it can drain. However, do not move the victim if a neck or back injury is suspected. Get medical help. 3. If the eardrum has been ruptured (Initially, there will be severe pain.), place sterile cotton gently in the outer ear canal to keep the inside of the ear clean. Get medical help. FIRST AID FOR OBJECT IN THE EAR 1. Calm and reassure the victim. 2. Do not attempt to remove the foreign object by probing with a cotton swab or any other tool. 3. If the object is clearly visible at the entrance of the ear canal, and it can be easily grasped with tweezers, gently remove it. Then, get medical help to make sure the entire object was removed. 4. If you think a small object may be lodged within the ear, but you cannot see it, do not reach inside the ear canal with tweezers. You can do more harm than good. Get medical help. 5. Try using gravity to get the object out by tilting the head to the affected side. Do not strike the victim's head, but shake it gently in the direction of the ground to try to dislodge the object. 6. If the object is an insect, don't let the victim put a finger in their ear since this may make the insect sting. First, turn the victim's head so that the affected side is up, and wait to see if the insect crawls out. If this doesn't work, try to gloat the insect out by pouring mineral oil, olive oil, or baby oil into the ear. It should be warm, but not hot. As you pour the oil, you can ease the entry of the oil by straightening the ear canal: pull the ear lobe gently backward and upward for an adult, or backward and downward for a child. The insect should suffocate and may float out in the oil bath. Avoid using oil to remove any object other than an insect, since oil can cause other kinds of objects to swell. |
| Do Not | DO NOT block any drainage coming from the ear. DO NOT try to clean drainage or irrigate inside the ear. DO NOT attempt to remove the foreign object by probing with a cotton swab, 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. |
| Call immediately for emergency medical assistance if | You suspect any serious head injury . First aid methods are unsuccessful and the victim is experiencing pain, reduced hearing, dizziness, or a sensation of something lodged in the ear. |
| Prevention | Never put anything in the ear canal without first consulting a physician. Never thump the head to try to correct an ear problem. Following an ear injury , avoid nose blowing and getting water in the injured ear. Teach children not to put things in their ears. Avoid cleaning the inner ear canals altogether. |
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