A foreign object in the ear is a common scenario encountered in day to day life. Children may put various small objects in ear while playing and may get stuck. Adults may face this situation while in an attempt to clear the ear of earwax or water using various objects. In both above categories small insects may crawl in to the ear and will cause extremely uncomfortable situation due to its buzzing and movement in ear canal.
In most of the cases these foreign objects are not harmful and can be removed at house with proper first aid management. However, button batteries (may leak and cause severe chemical damage within hours), sharp objects, food and organic matter (may swell and get infected) can pose a serious threat and require urgent medical attention.
As the skin of ear canal is extremely sensitive, presentation is quite straightforward in adults due to pain or irritation. In case of small children who are unable to verbalize the pain, diagnosis can be quite challenging as child may present with excessive crying, irritability with redness and discharge from ear at later stages. Mostly the panic caused by the object/insect in the ear complicate the safe removal of it at first aid setting. Therefore, first aid training should focus on calming down the victim and attempt a safe removal of harmless and removable objects, while identifying serious conditions that require immediate medical attention.
Refer the patient for urgent medical attention if there is;
• Severe pain.
• Increasing pain.
• Redness and swelling of ear, ear canal and skin around ear.
• Button battery or organic object in ear.
• Drainage from ear.
• Hearing loss, dizziness or bleeding.
• Failure to safely remove the object.
First aid for an object in ear;
1. Calm down the patient and reassure him/her. Most objects can be removed safely if the patient is cooperating.
2. Use a good light and examine the ear for the object, whether there is any swelling, redness or discharge. Pull the ear up and back to straighten the ear canal and see deeper inside.
3. While pulling the ear back, tilt the head to the affected side and shake it to dislodge the object. Do not hit the opposite side of the head.
4. If the object is visible and the victim is cooperating; try to remove it carefully using a blunt ended tweezers. Be gentle and careful not to push the object further in to the ear. Use this method only to grab the objects within the depth where you can see the tips of tweezers.
5. Do not use non gripping tools like cotton swabs, match sticks and bobby pins.
6. Do not syringe water in to the ear.
7. Do not try to remove the object if the person is panicked and not holding still.
To remove a button battery;
1. If it’s visible try to remove it as described above.
2. Most importantly DO NOT put any liquids (water, ear drops, oil etc.) in the ear. These will accelerate the corroding and leakage of chemicals from the battery.
To remove an insect;
1. First calm down the victim. Buzzing and movement of the insect can be very distressing.
2. Tilt the head so that the affected ear is up. Pull the earlobe back and up to straighten up the ear canal.
3. Slowly pour few drops of lukewarm baby oil, mineral oil or olive oil into the ear.
4. The insect will be suffocated and may float out. Or else it will be killed and patient will be free of distress until proper removal either by tweezers or at hospital.
5. Do not use oil for any other objects.
6. Do not use this method if there is a hole is ear drum (a grommet placed by surgery), or there is bleeding from ear canal.