When administering eardrops to a child under the age of three how should their ear be positioned?

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Ear Drops Medication Administration

Ear Drops Medication

Administering ear medication is a fundamental skill that requires the nurse to either irrigate the ear canal or carefully place drops into the ear canal. Be sure to administer the medication as ordered and in the correct ear. While performing the procedure, educate the patient on proper techniques for home care.

10 KEY FACTS

Some individuals produce an excess of earwax. In some cases, a blockage or impaction of cerumen can occur, and the ear may need to be irrigated to clean the canal out.

Ear infections (acute otitis media) occur when fluid becomes trapped in the middle ear. Pressure can build up, causing pain and diminished hearing on the affected side. Antibiotic drops can be used to treat the infection. Educate the patient to administer medication as prescribed and to finish antibiotic therapy.

To straighten out the ear canal in children less than 3 years of age, pull the Pinna/Auricle (outer part of the ear) back and downwards. This method administers a drop more accurately into the ear by permitting gravity to pull it down. “Child” has the letter “D” for Downward.

To straighten the ear canal for adult patients, you need to pull the Pinna/Auricle (outer part of the ear) back and upwards. This method administers a drop more accurately into the ear canal by allowing gravity to pull it down. “Adult” has a “U” for Upward.

To allow gravity to assist the medication into the middle ear, place the patient on the side with the ear facing up.

When administering a drop, hold the dropper about 1 cm (1/2 inch) above the ear canal while holding the Pinna in the proper position. Do not allow the tip of the dropper to make contact with your hands or the patient. The solution is sterile, and the tip needs to be kept clean.

To allow the medication time to travel to the middle ear and not drain out, keep the patient in the side-lying position or keep the ear facing upward for 2-3 minutes.

The inner ear is sensitive to temperature changes. To prevent vertigo, dizziness, or nausea, make sure the solution is kept at room temperature.

To help disperse the medicine in the ear, you can gently massage the tragus unless contraindicated because of pain.

If drainage is present, confirm that the patient’s eardrum is not perforated. If so, this would be a contraindication for administering the ear drops. If irrigating the ear canal, never put a syringe directly into the canal or forcefully put medication in the ear canal, the pressure could perforate the eardrums.

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This page explains how to give your child ear drops or spray and how to look after these types of medicine.

What to do

  1. Wash your hands.
  2. Get your child into any of these positions, with the ear you are treating facing upwards:
    • Tilt your child’s head back and to one side.
    • Lay your child flat on his or her back.
    • Ask someone to hold your child in a safe position as above.
    • Wrap your baby or young child in a light blanket or sheet to keep his or her arms and legs still.
  3. Shake the bottle or spray.
  4. Remove the top of the bottle or spray and throw away the plastic seal.
  5. Gently pull your child’s earlobe backwards to open up the ear canal.
  6. Put the prescribed amount of drops or spray into the ear canal.
  7. Keep your child in this position for a few minutes so the drops or spray can spread inside the ear.
  8. If your child needs drops or spray in the other ear, turn him or her over so that the other ear is facing upwards and repeat the above steps.
  9. Put the top back on the bottle or spray.

Looking after your child’s ear drops or spray

  • Always check the expiry date of the medicine before giving it to your child.
  • Keep the bottle or spray tightly closed in a cool, dark place according to the label.
  • Read the instructions on the label and only use the drops or spray in the affected ear(s).
  • Ear drops or sprays should not be used longer than stated on the label. If you are giving your child ear drops or spray for a certain number of days, write the date you open the bottle on the label so you will know when to throw it away.
  • Keep all medicines out of the reach of children.

If you have any questions about your child’s ear drops, please ask your family doctor (GP) or local community pharmacist.

Compiled by:

The Pharmacy department in collaboration with the Child and Family Information Group.

Last review date:

April 2020

How will you instill ear drops for a child below 3 years of age?

For children under age 3: Gently pull the outer flap of the affected ear DOWNWARD and backward to straighten the ear canal. Look for the ear canal to open.

What is the best position for ear drops?

Lie down with your affected ear facing up. Gently pull your ear back to help straighten the ear canal. Hold the dropper over the ear and squeeze out recommended drops (typically 4 to 5 drops of antibiotics per dose).

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