713: Wk 2 Otitis Media & Externa
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| OM clinical findings | show 🗑
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| show | Full/ bulging tympanic membrane, decreased or absent mobility on insufflation, opaque tympanic membrane, otorrhea, (erythema of TM is not diagnostic)
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| show | Tympanocentesis of fluid id of causative organisms indicated 1) fail abx tx , suspected or confirmed complication, OM in neonate, sick neonate, immulogically compromised pt,
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| Causative organisms | show 🗑
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| show | HIB vaccine, & prevnair (pneumococcal) vaccine
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| show | Antibiotic therapy
Amoxicillin 80-90mg/kg/day
Augmentin 40mg/kg/day
Cephlasporins
Ceftin
Omnicef
Cefzil
Zithromax
Biaxcin
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| Management of OM | show 🗑
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| show | Defined as a chronic bacterial infection persisting more than 2 weeks
Terms used synonymously
Secretory otitis
Serous otitis
Chronic purulent otitis
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| OM with effusion | show 🗑
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| Causative organisms of OM with effusion | show 🗑
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| Management of OM with effusion | show 🗑
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| show | -watch & wait: reexamine 3 mth, refer at 6. Nonsurgical- abx = acute OM. Surgical: myringotomy with aspiration of fluid, PE tubes.
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| show | Distinct acute episodes interspaced by periods of complete resolution- these are kids that need PE tubes
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| show | First episode at age less than 6 months
Siblings in home
Patient is male
Formula fed
Day care attendance
Cigarette smoke in home
Cold weather months of the year
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| Rx for recurrent AOM | show 🗑
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| show | Referral means surgery
4-5 episodes of acute OM in a season
Refractory disease
Mastoiditis
Speech/language delay
Hearing loss
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| Otitis Exerna | show 🗑
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| show | >2 years of age
Swelling of ear canal
Erythema and purulent exudate
Mild to severe otalgia, especially with movement of the pinna
Can be associated with concomitant acute otitis media, hearing loss, ear fullness, pressure, pruritis, and severe deep pa
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| Causative pathogens of ostitis externa | show 🗑
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| Management & tx of otitis externa | show 🗑
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| show | Solutions of half alcohol and vinegar instilled into ear after swimming
Molded ear plugs
Particularly for PE tubes
Referral
Draining ear that persists for greater than 2 weeks with treatment
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| Cholesteotoma | show 🗑
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| show | Cholesteotoma, hearing loss, speech delay, mastoiditis, perforation, meningitis
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Created by:
JennRN
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