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Not so long ago I reviewed a range of otoscopes. In that review, I recommended a few options for home use.

Anyway, since then I have received quite a few emails from various readers on how to use an otoscope at home to check for ear infections.

I am always happy to answer these questions, and really appreciate my readers getting in touch.

All the same, I thought it would be a nice idea to create a short guide for those that might have bought an otoscope that I have recommended and are a little unsure on how to use it.

So that’s exactly what we will do now… Let’s take a look.

The dreaded ear infection

If you have children, an ear infection is a very common thing, especially when in preschool.

Mine used to get them regularly during the summer-long after they left nursery too, due to the amount of time they spent swimming in a neighbor’s pool.

If your child suffers from ear infections regularly enough, it does make sense to buy one otoscope so that you can check the ear yourself, without having to drag them to a doctor.

This is no problem at all, and otoscopes (as we will see) are simple enough to use at home.

One word of warning, however. If your child’s ear actually shows signs of leaking blood or pus, I would not try any home diagnosis and book an appointment with your GP instead.

There could be a serious infection that you might only make worse by prodding around in there.

The same applies when there’s any indication of damage to the outer ear, such as swollen skin or red coloration to the bone behind the ear.

Right, with those precautions out of the way let’s quickly recap on what an otoscope is.

What Is an Otoscope?

Essentially, the otoscope is an instrument doctors use to see inside the ear. They are a specialist tool, however, you can very easily buy them online for home use.

It is important that you use one properly, mind you.

The otoscope comes with several pointed tips, called specula and these have to be placed onto the instrument so that you can look inside your child’s ear.

You should choose a specula that is slightly smaller than the opening of your child’s ear. Unless you are using disposable specula it should also be cleaned thoroughly before use.

How to use an otoscope to check for ear infection?

With the correct specula in place, (if your smallest specula is too large for your child’s ear, you will need to see a doctor instead), it is time to switch on the instrument’s light.

With a baby younger than 12 months, pull the outer ear gently outwards to straighten the ear canal so that you can see inside.

For an older child, you should pull the outer ear gently up and back. You may have to distract them with some strategic screen time, or some other distraction to stop them from squirming.

Each child is different of course.

With the ear canal exposed, place the specula gently into the entrance to the ear.

Your little finger should be stretched out from the handle and rest on your child’s cheek. This helps steady the path of the otoscope while ensuring you do not press too far inside the ear.

Look into the viewing end of the otoscope and gently move the otoscope forward so the eardrum is visible.

Needless to say, this should be done very slowly.

You may need to angle the viewing piece slightly toward your child’s nose. This helps to ensure that the angle of the instrument is following the direction of the ear canal.

Getting the angle correct for a proper viewing is often the most difficult part of the procedure. It may take a bit of practice, and is especially difficult if your child is protesting.

If this is the case, you may need to stop to calm them down. Explaining what you are doing as you go can help. As can the aforementioned distraction method.

What to look for inside the ear

Knowing what to look for is clearly an important part of the otoscope exam.

Thankfully, infection normally makes itself known in obvious ways.

A red, sore-looking eardrum is a tell-tale sign of infection. As is fluid behind the eardrum. This can be waxy and yellow-looking, or clear.

If you suspect a hole in the eardrum it could mean that it is perforated. Any sign of blood is clearly an issue too.

If there are any signs of the above, you should take your child to the doctor as soon as you can.

About Hannah Drake

Hannah Drake, RN, CSP is a registered nurse and owner and founder of Nurse Focus. Her nursing career spans almost two decades, and in that time she has developed her skill base across a variety of settings, including med surg nursing, clinical informatics system administration and implementation, and healthcare community management. Contact Hannah.

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