Term
Cerumen Management:
-cerumen ___ by audiologist (or other) and/or ___ patients to physician for cerumen removal |
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Definition
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Term
List 7 precautions related to cerumen management:
1. Check with licensure ___; read licensure ___; CM is within scope of practice (but is ___ by some licensure boards)
2. Check with licensure board to see if any ___ exist that restrict CM procedures
3. Check with professional ___ ___ carrier
4. Investigate any restrictions in specific ___ ___
5. Follow the ___ ___ ___
6. Have a plan for ___ ___
7. Obtain informed ___ from patients |
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Definition
| board; laws; prohibited; limitations; liability; insurance; work place; CDC’s Standard Precautions; medical emergencies; consent |
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Term
| Recognize 4 risks of cerumen removal |
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Definition
-Abrading ear canal wall (bleeding, infection)
-Perforating TM
-Making chronic middle ear disorder worse
-Damaging ossicular chain |
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Term
| What are some contraindications to cerumen removal in relation to case history? |
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Definition
i. Recent or current chronic OM
ii. External otitis
iii. Post ear surgery
iv. Diabetes (no water)
v. Chronic bleeding disorders
vi. Aids/hepatitis
vii. Hx of treatment for external ear disorders |
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Term
| What are some contraindications to cerumen removal in relation to medications? |
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Definition
i. Anticoagulants/antiplatelets-blood thinner
ii. Thrombolytic medications-Clot busting drug
iii. Prescription ear drops/creams
iv. Steroids, chemotherapy medications
v. Herbal supplements/vitamins-Some supplements can thin blood |
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Term
| What are some contraindications to cerumen removal in terms of otoscopy? |
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Definition
i. Ear drainage/discharge
ii. Tubes
iii. TM perforation
iv. Dried or cracked skin
v. Open wound
vi. Foreign bodies
vii. Inability to visualize TM |
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Term
| What are some general contraindications of cerumen removal? |
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Definition
| Ear pain, ear drainage, ear surgery, dizziness, diabetes mellitus, AIDS, and any other conditions that would put patients at risk (e.g. middle ear disorder, CHL, mixed loss, type B tymp & large ECV) |
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Term
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Definition
Agents that soften ear wax. Active ingredients:
Carbamide peroxide (6.5%) & glycerin |
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Term
| List at least 4 ceruminolytics |
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Definition
| Audiologists’ choice, Debrox, Murine Ear Drops, and Bausch & Lomb |
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Term
| What are the 3 methods of cerumen removal? |
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Definition
| Mechanical removal, suction, and irrigation |
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Term
Mechanical Removal:
-Most ___
-Indicated for ___ occluded canals & when wax is not ___ to skin
Requires ___ instruments: Wire loops, curettes, forceps, alligator forceps, otoscope specula, some audiologists use operating microscope, some use fiber-optic headlamp to have
both hands free |
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Definition
| common; partially; adhered; sterile |
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Term
Suction - Indications:
-Indicated when wax is very ___, semi-___ and near canal ___
-Device may get ___, have ___ water nearby to unclog suction device
-Do not suction ___ pieces of cerumen
- Noise may be annoying, may cause _______, may NOT be ___ by some |
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Definition
| soft; liquid; entrance; clogged; warm; large; TTS; tolerated |
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Term
Irrigation – Indications & Equipment:
-Use with more ___ occlusions & when wax is ___ and ___
-Yields ___ canal, but water may ___ in EAC
-Equipment: oral jet irrigator on LOW setting. Can order special ___ to deflect water stream. Basin, ___ for patients, curettes |
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Definition
| complete; hard & dry; cleaner; stay; tips; cover |
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