Expert NP Playbook for Ears

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Interested in becoming a better steward of antibiotics for ear complaints? Antibiotics are overused for adult ear complaints a very large percentage of the time in the urgent care setting. Find out the most common cause of adult otalgia in the absence of otitis externa (hint: it’s NOT otitis media) and significantly reduce your antibiotic usage.

Find out how to prove to yourself..and your adult patient –  that ear pressure is not always synonymous with middle ear fluid.  Learn the common tympanic membrane conditions that give the appearance of middle ear fluid – and simple tests to prove the presence or absence of middle ear fluid (one actually will actually generate revenue for your clinic).

Is that acute otitis media in that 5 year old or just a hyperemic tympanic membrane because he is crying? Learn how to tell the difference.

Do you relay only on ear irrigation for cerumen removal? Do you know the contraindications to ear irrigation? Learn what repercussions ear irrigation can cause – and what other techniques urgent care providers should have in their arsenal.

Full Description

Ears are difficult and often misdiagnosed in the urgent care setting. As an otolaryngologist, I see antibiotics overused frequently for adult patients that are misdiagnosed with acute otitis media when they are actually suffering from a flare up of temperomandibular disorder. We go over how to diagnose this condition, how to treat it, and help UC providers to become much better stewards of antibiotics.

Patients with acute hearing loss in the UC setting are often told they have middle ear fluid (conductive hearing loss) when the patient actually has a sensorineural hearing loss (SNHL). SNHL is a time sensitive ENT urgency – and the patient is at increased risk of permanent hearing loss in the affected ear if not started on high dose steroids with urgent ENT referral within 2 weeks. ENT can offer transtympanic steroid injection to preserve hearing. This course will present simple diagnostic methods to help confirm conductive versus neural hearing loss.

Ear pressure/fullness is a common presentation to an UC provider. This course will go over other common causes of ear pressure besides eustachian tube dysfunction which commonly present to the UC. Patients with vertiginous migraines or Ménière’s disease frequently have ear fullness as their only presenting symptom at an UC. We go over a case presentation to help providers remember to ask about dizziness, hearing fluctuation, and tinnitus to these patients – and help get the diagnosis correct.

Cerumen removal is most commonly removed with ear irrigation. As an otolaryngologist, I see the complications of ear irrigation on a regular basis. In the course, we go over other cerumen removal methods to encourage UC providers to expand their cerumen removal arsenal.

Additional information

Source

Compassio Medical Education

Contributor

Jeff LaCour, MD, Dylan Pietrantoni, MS3

Publication Date

07/03/2024

Future Review Date

08/19/2027

Format

e-book

Length

1 hour