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When not to syringe an ear

P Blake1, R Matthews, J Hornibrook

  • 1Wellington Hospital, Wellington School of Medicine.

The New Zealand Medical Journal
|December 23, 1998
PubMed
Summary

Ear syringing can cause iatrogenic injuries, with drum perforation being the most common severe outcome. Practice nurses performed syringing in most cases of significant injury, highlighting the need for proper technique and contraindication awareness.

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Area of Science:

  • Otolaryngology
  • Medical Safety
  • Patient Injury Analysis

Background:

  • Ear syringing is a common procedure for earwax removal.
  • Potential complications and iatrogenic injuries associated with ear syringing are a concern.
  • The Accident Compensation Corporation (ACC) Medical Misadventure Unit receives claims related to such injuries.

Purpose of the Study:

  • To review the potential hazards of ear syringing.
  • To analyze the ACC Medical Misadventure Unit's experience with alleged iatrogenic injuries from ear syringing over a 17-month period.
  • To identify common injuries, contributing factors, and provide guidance on correct technique and management.

Main Methods:

  • Retrospective review of claims submitted to the ACC ENT Medical Misadventure Committee.
  • Analysis of accepted and declined claims related to ear syringing.
  • Categorization of injury types and severity.
  • Identification of healthcare professionals involved in the procedures.

Main Results:

  • Ear syringing claims constituted approximately 25% of total claims to the ACC ENT Medical Misadventure Committee.
  • Out of 110 claims, 47 were accepted (mishap or error) and 63 were declined.
  • Perforation of the tympanic membrane was the most frequent injury leading to significant disability.
  • Severe iatrogenic otitis externa was the second most common injury.
  • Practice nurses performed ear syringing in about two-thirds of claimants with significant disability.

Conclusions:

  • Ear syringing carries significant risks, including drum perforation and otitis externa.
  • Practice nurses were frequently involved in cases of significant iatrogenic injury.
  • Adherence to contraindications and correct syringing technique is crucial to minimize patient harm.
  • Proper management protocols for unintentional injuries are necessary.

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