An ear instillation is a solution of topical medicine prepared for administration into the ear canal. Medicine instilled into the ear is absorbed through the skin of the ear canal and membranes of the eardrum.
Ear instillations are used primarily to treat wax build-up and inflammations or infections of the ear.
Do not place the medicine dropper tip or cotton swabs directly into the ear canal, as this can traumatize the skin of the ear canal. Do not touch anything with the tip of the medicine dropper to prevent contamination. If the patient experiences pain from eardrops, stop using the medicine and contact the physician.
To instill eardrops, have the patient lie on his or her side with the affected ear up. Gently pull the lobe of the ear up and back to open the ear canal (down and back for children under the age of three). Hold the medicine dropper just above the entrance to the ear canal and squeeze out the correct number of drops. Release the ear and have the patient remain still for five minutes to allow absorption of the eardrops. Repeat the procedure on the other ear if ordered.
The hands should be washed before administering ear drops. Check the medication label each time to avoid medication errors. Be sure it is the right medicine, the right dose (strength), the right time, the right person and the right method. Look at the expiration date on the label. Do not use outdated medicine. Warm the eardrops to body temperature by rolling the bottle in the hands for several minutes before the instillation.
Have tissues or a warm washcloth available to wipe off residual medicine that may drip out of the ear when the patient sits up. A small piece of clean cotton ball may be placed into the outer portion of the ear canal to absorb excess medicine if desired. Discard soiled tissues and cotton in a bag that can be closed and discarded. Wipe the tip of the ear dropper with a clean tissue and recap the bottle. The hands should be washed again after completing the procedure.
Excessive use of eardrops can cause irritation and inflammation of the skin and membranes of the ear.
Ear instillations will produce the desired results within a few days. Contact the physician if the patient experiences ear pain at the time of medicine instillation, or if the condition does not improve.
Health care team roles
Ear instillations are usually administered by a licensed nurse (R.N. or L.P.N.) in the health care setting. The patient or members of the patient's family can be taught to instill ear medicines in the home setting.
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Mary Elizabeth Martelli, R.N.,B.S.