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TROLLEY PREPARATION FOR
  EAR, NOSE AND THROAT
      EXAMINATION




        Free Powerpoint Templates
ENT EXAMINATION

Purpose:

To detect any abnormalities of
ear, nose and throat.
ANATOMY OF EAR
EQUIPMENTS FOR EAR
   EXAMINATION
HEAD LIGHT
 Used to get clear vision of the ear canal or
  ENT procedure.
TUNING FORK
• To determine whether a
  hearing loss is conductive or
  perceptive.

• Can be Weber test or Rinne
  test.
OTOSCOPE
 To examines the auditory canal and
 tympanic membrane for infection or
 blockage due to the presence of a
 foreign object or build up of wax.
AURAL
SPECULUM
 A cone or funnel shaped
 attachment for an
 otoscope which is
 inserted into the ear canal
 to examine the eardrum.
ZOELLNER
SUCKER

• used for suction in
  middle ear.
CROCODILE
FORCEP

• To remove foreign body
  from ear, nose, throat
  (ENT) procedure.
JOBSON-HORNE PROBE

used for removal of wax and cleaning of ears.
ANATOMY OF NOSE
EQUIPMENTS FOR NOSE
   EXAMINATION
J - SUCKER




 Used for removal of crust at nose or discharge at
  opening ears.
THUDICUM NASAL
 SPECULUM
•   Used for visualization of external nose.
VIENNA NASAL
SPECULUM
used in:
• Anterior nasal packing
• Septoplasty
• Removal nasal foreign body
   and rhinolith (calculus
   present in the nasal cavity).
RIGID SCOPE
This exam allows a complete
and detailed visualization of
all nasal mucosa, nasal
turbinates, openings into the
sinuses, and nasopharynx.
FLEXIBLE
SCOPE
• To help examine places
  that are hard to reach.
TILLEY FORCEP
• To perform anterior nasal packing.
• To remove foreign bodies, crusts or
  packs from the nose.
• To pack the nose with gauze strips
  during nasal surgeries or sinus
  surgeries.
• To remove cartilage and bone pieces
  during septoplasty
SINUS FORCEP
 Used for removing or inserting
  dressing packs.
ANATOMY OF THROAT
EQUIPMENTS FOR THROAT
     EXAMINATION
To suppress the tongue to allow
 for examination of the mouth
 and throat
LACK’S
 SPATULA
 Airway patency can be tested by
  placing a cold Lack's depressor
  underneath and asking the
  patient to exhale

 To depress the tongue
Pentorch




           Glove
LARYNGEAL
MIRROR
For oral examinations.
POSTERIOR
LARYNGEAL
MIRROR / PNS
MIRROR

 For posterior rhinoscopy (seeing
the inner parts of the nose like the
choanae)
FLEXIBLE SCOPE
 To help examine places that are
 hard to reach.
Ent trolley n drug
WHAT IS OTOTOXIC DRUG
 Medications that can damage the ear, resulting
 in hearing loss, ringing in the ear, balance
 disorders and deaf.
WHAT IS OTOTOXICITY
 Ototoxicity is damage to the hearing or balance
  functions of the ear by drugs or chemicals.
 Ototoxic drugs may cause lack of hearing, and
  loss of sense of balance.
DRUG CAN CAUSE
OTOTOXITY :
1. Antibiotics
 streptomycin
 neomycin
 gentamicin (Garamycin)
 erythromycin (E-Mycin, Eryc)
 kanamycin (Kantrex)
 tobramycin (Nebcin)
 netilmycin (Netromycin)
 vancomycin (Vancocin)
CONT
2. Anti-cancer drugs
 cisplatin (Platinol AQ)
 bleomycin (Blenoxane)
 vincristine (Oncovin)
CONT
3. Diuretics
 acetazolamide (Diamox)
 furosemide (Lasix)
 bumetanide (Bumex)
 ethacrynic acid (Edecrine)
CONT
4. CARDIOVASCULAR AGENTS
 Captopril
 Digitalis
 Guanfacine
 Metroprolol
 Minoxidil (also for alopecia)
 Quinidine
 Tocainide
ENT MEDICATION
OTIC/EAR AGENT
OTIC/EAR AGENT

 ANTIBIOTIC
 LOCAL ANALGESICS
 STEROIDS
 WAX EMULSIFIERS
ANTIBIOTIC
 Indication :
- To reduce the inflammation & itching associated with
  ear infection.
ANTIBIOTIC con’t
 Example :
i) Neomycin
ii) Ciprofloxacin (Cetraxal)
iii) Ofloxacin (Floxcin Otic)
iv) Gentamycin
v)Gramicidin
vi) Nystatin
vii) Framycetin
LOCAL ANASTHETICS
 Inducation
-To reduce pain in the ear.

 EXAMPLE:
i)Benzocaine (Americaine Otic and Otocain)
 ii)Pramoxine
STEROID
 Indication :
-To treat inflammation of the skin of the ear canal.

 Example:
i)Hydrocortisone
ii)Dexamethasone (Dexasol)
iii)Fluocinolone acetonide (Dermotic Oil Ear Drops).
WAX EMULSIFIER
(CERUMENOLYTIC)
 Indication :
 Loosen and remove impacted cerumen(ear wax)


 EXAMPLE:
i)Carbamide peroxide (Debrox)
ii)Triethanolamine polypeptide oleate (Cerumenex)
COMBINATION OF EARDROP
 Indication :
-To treat multiple aspects of otitis media or otitis externa (anti-
  inflammatory , anti-pruritic,anti-allergic)


Example:


 A) Combination of Antipyrine and Benzocaine
   (Brand names: Antiben, Auralgan,Otocalm).
Combination Ear Drops (cont..)
  B)Antibiotic and Steroid :

  Chloroxylenol/hydrocortisone/pramoxine (Brand name:
   Aero Otic HC, Cortamox)
  Chloroxylenol/pramoxine
  (Brand Name: Pramotic, Uni-Otic)
  Hydrocortisone/neomycin/polymyxin B
  (Brand Names: Cortisporin Otic)
  Ciprofloxacin/dexamethosone
  (Brand Name: Ciprodex).
DRUGS FOR NOSE
DRUGS FOR NOSE
 ANTIHISTAMINES
 Indication :
- To treat allergic rhinitis
 Example :
i)  Cetrizine
ii) Chlorphinaramine diphenhydramine ( benadryl)
DRUGS FOR NOSE con’t
DECONGESTANTS
- Commonly used for their ability to shrink engorged
  nasal mucus membrane & relieve nasal stiffness.
 Indication :
- Acute & chronic rhinitis , common cold
- Sinusitis , fever & other allergies
EXAMPLE OF DECONGESTANT
DRUG
  1) Nasal prophylaxis :
     Budesonide (Pulmicort Tubuhaler, Rhinocort)

  2) Treatment of seasonal & perennial allergic rhinitis :
     Nasacort (Trimcinolone)

  3) Bronchodilator:
     Atrovent (Ipratropium)

  4) Nasal congestion and as adjunct for sinusitis :
     Naphazoline (Privine)
DRUGS FOR THROAT
DRUGS FOR THROAT
ANTITUSSIVES
 Indication :
- To stop cough reflex whe the cough is non productive
  or harmful.
- Reduce runny nose & postnasal drip.
Example of Drugs
1) Codeine (Opoid Antitussives)
2) Dextromethor (Non-opoid Antitussive)
3) Hydrocodone (Hycodan)
Ent trolley n drug
EAR DROP
   Also known as otic drop.

   It is liquid medicine administered into the ear.

   Must be discard after 30 days once open.

   Do not share ear drop: 1 medication 1 patient.
OTIC AGENTS:

 Antibiotics

 Antifungals

 Anti-inflammatory agents

 Wax emulsifiers

 Local analgesics
ANTIFUNGAL AND
          ANTIBACTERIA
 Indication: treatment of superficial infections of
 the external auditory canal caused by
 organisms.

 Side effects: burning, redness, rash, swelling
 and other sign of topical irritation

 E.g: chloramphenicol & gentamycin
ANTIBIOTIC AND STEROID
COMBINATION
 Indication: to reduce the inflammation and
 itching associated with ear infection.

 E.g: pramoxine, benzalkonium chloride,
WAX EMULSIFIER
 To soften the ear wax / cerumen.


 Contraindication:
  -Otitis external
  -Dermatitis
  -Perforated ear drum


 E.g: Carbamide peroxide.
EQUIPMENT
   Tray
   Cotton buds
   Sterile galipot
   Normal saline
   Ear drop as prescribe
   Receiver (kidney dish)
   MOAR
   Cotton ball
TECHNIQUE
> Adult
  - Pull upward and backward.

> Child
  - Pull downward and backward..
IMPLEMENTATION
1. Greet and explain clearly about the
procedure to the client.
   - Purpose of instillation

2. Ask for client’s name and date of
birth, compare with client’s ID tag.

3. Check doctor’s prescription.
  - Choose correct ear drop and check with
the prescription.
Con’t…
4. Position the client lie in the bed on unaffected
ear.

5. Clean the ear using swab sticks moistened with
normal saline.

6. Check ear drop medication with 8 R.
Con’t…
7. Pull ear upward and backward for
adult, downward and backward for children.

8. Hold tip of the bottle 1cm directly above
meatus.

9. Instill the ear drops.
Con’t…
10. Apply tragus pressure lightly.

11. Make sure client still in this position at least 3-5
minute.

12. Clean the equipment.

13. Document administration of medication.
Ent trolley n drug

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  • 1. TROLLEY PREPARATION FOR EAR, NOSE AND THROAT EXAMINATION Free Powerpoint Templates
  • 2. ENT EXAMINATION Purpose: To detect any abnormalities of ear, nose and throat.
  • 4. EQUIPMENTS FOR EAR EXAMINATION
  • 5. HEAD LIGHT  Used to get clear vision of the ear canal or ENT procedure.
  • 6. TUNING FORK • To determine whether a hearing loss is conductive or perceptive. • Can be Weber test or Rinne test.
  • 7. OTOSCOPE To examines the auditory canal and tympanic membrane for infection or blockage due to the presence of a foreign object or build up of wax.
  • 8. AURAL SPECULUM A cone or funnel shaped attachment for an otoscope which is inserted into the ear canal to examine the eardrum.
  • 9. ZOELLNER SUCKER • used for suction in middle ear.
  • 10. CROCODILE FORCEP • To remove foreign body from ear, nose, throat (ENT) procedure.
  • 11. JOBSON-HORNE PROBE used for removal of wax and cleaning of ears.
  • 13. EQUIPMENTS FOR NOSE EXAMINATION
  • 14. J - SUCKER  Used for removal of crust at nose or discharge at opening ears.
  • 15. THUDICUM NASAL SPECULUM • Used for visualization of external nose.
  • 16. VIENNA NASAL SPECULUM used in: • Anterior nasal packing • Septoplasty • Removal nasal foreign body and rhinolith (calculus present in the nasal cavity).
  • 17. RIGID SCOPE This exam allows a complete and detailed visualization of all nasal mucosa, nasal turbinates, openings into the sinuses, and nasopharynx.
  • 18. FLEXIBLE SCOPE • To help examine places that are hard to reach.
  • 19. TILLEY FORCEP • To perform anterior nasal packing. • To remove foreign bodies, crusts or packs from the nose. • To pack the nose with gauze strips during nasal surgeries or sinus surgeries. • To remove cartilage and bone pieces during septoplasty
  • 20. SINUS FORCEP  Used for removing or inserting dressing packs.
  • 22. EQUIPMENTS FOR THROAT EXAMINATION
  • 23. To suppress the tongue to allow for examination of the mouth and throat
  • 24. LACK’S SPATULA  Airway patency can be tested by placing a cold Lack's depressor underneath and asking the patient to exhale  To depress the tongue
  • 25. Pentorch Glove
  • 27. POSTERIOR LARYNGEAL MIRROR / PNS MIRROR For posterior rhinoscopy (seeing the inner parts of the nose like the choanae)
  • 28. FLEXIBLE SCOPE To help examine places that are hard to reach.
  • 30. WHAT IS OTOTOXIC DRUG  Medications that can damage the ear, resulting in hearing loss, ringing in the ear, balance disorders and deaf.
  • 31. WHAT IS OTOTOXICITY  Ototoxicity is damage to the hearing or balance functions of the ear by drugs or chemicals.  Ototoxic drugs may cause lack of hearing, and loss of sense of balance.
  • 32. DRUG CAN CAUSE OTOTOXITY : 1. Antibiotics  streptomycin  neomycin  gentamicin (Garamycin)  erythromycin (E-Mycin, Eryc)  kanamycin (Kantrex)  tobramycin (Nebcin)  netilmycin (Netromycin)  vancomycin (Vancocin)
  • 33. CONT 2. Anti-cancer drugs  cisplatin (Platinol AQ)  bleomycin (Blenoxane)  vincristine (Oncovin)
  • 34. CONT 3. Diuretics  acetazolamide (Diamox)  furosemide (Lasix)  bumetanide (Bumex)  ethacrynic acid (Edecrine)
  • 35. CONT 4. CARDIOVASCULAR AGENTS  Captopril  Digitalis  Guanfacine  Metroprolol  Minoxidil (also for alopecia)  Quinidine  Tocainide
  • 38. OTIC/EAR AGENT  ANTIBIOTIC  LOCAL ANALGESICS  STEROIDS  WAX EMULSIFIERS
  • 39. ANTIBIOTIC  Indication : - To reduce the inflammation & itching associated with ear infection.
  • 40. ANTIBIOTIC con’t  Example : i) Neomycin ii) Ciprofloxacin (Cetraxal) iii) Ofloxacin (Floxcin Otic) iv) Gentamycin v)Gramicidin vi) Nystatin vii) Framycetin
  • 41. LOCAL ANASTHETICS  Inducation -To reduce pain in the ear.  EXAMPLE: i)Benzocaine (Americaine Otic and Otocain) ii)Pramoxine
  • 42. STEROID  Indication : -To treat inflammation of the skin of the ear canal.  Example: i)Hydrocortisone ii)Dexamethasone (Dexasol) iii)Fluocinolone acetonide (Dermotic Oil Ear Drops).
  • 43. WAX EMULSIFIER (CERUMENOLYTIC)  Indication :  Loosen and remove impacted cerumen(ear wax)  EXAMPLE: i)Carbamide peroxide (Debrox) ii)Triethanolamine polypeptide oleate (Cerumenex)
  • 44. COMBINATION OF EARDROP  Indication : -To treat multiple aspects of otitis media or otitis externa (anti- inflammatory , anti-pruritic,anti-allergic) Example:  A) Combination of Antipyrine and Benzocaine (Brand names: Antiben, Auralgan,Otocalm).
  • 45. Combination Ear Drops (cont..)  B)Antibiotic and Steroid :  Chloroxylenol/hydrocortisone/pramoxine (Brand name: Aero Otic HC, Cortamox)  Chloroxylenol/pramoxine (Brand Name: Pramotic, Uni-Otic)  Hydrocortisone/neomycin/polymyxin B (Brand Names: Cortisporin Otic)  Ciprofloxacin/dexamethosone (Brand Name: Ciprodex).
  • 47. DRUGS FOR NOSE  ANTIHISTAMINES  Indication : - To treat allergic rhinitis  Example : i) Cetrizine ii) Chlorphinaramine diphenhydramine ( benadryl)
  • 48. DRUGS FOR NOSE con’t DECONGESTANTS - Commonly used for their ability to shrink engorged nasal mucus membrane & relieve nasal stiffness.  Indication : - Acute & chronic rhinitis , common cold - Sinusitis , fever & other allergies
  • 49. EXAMPLE OF DECONGESTANT DRUG  1) Nasal prophylaxis :  Budesonide (Pulmicort Tubuhaler, Rhinocort)  2) Treatment of seasonal & perennial allergic rhinitis :  Nasacort (Trimcinolone)  3) Bronchodilator:  Atrovent (Ipratropium)  4) Nasal congestion and as adjunct for sinusitis :  Naphazoline (Privine)
  • 51. DRUGS FOR THROAT ANTITUSSIVES  Indication : - To stop cough reflex whe the cough is non productive or harmful. - Reduce runny nose & postnasal drip.
  • 52. Example of Drugs 1) Codeine (Opoid Antitussives) 2) Dextromethor (Non-opoid Antitussive) 3) Hydrocodone (Hycodan)
  • 54. EAR DROP  Also known as otic drop.  It is liquid medicine administered into the ear.  Must be discard after 30 days once open.  Do not share ear drop: 1 medication 1 patient.
  • 55. OTIC AGENTS:  Antibiotics  Antifungals  Anti-inflammatory agents  Wax emulsifiers  Local analgesics
  • 56. ANTIFUNGAL AND ANTIBACTERIA  Indication: treatment of superficial infections of the external auditory canal caused by organisms.  Side effects: burning, redness, rash, swelling and other sign of topical irritation  E.g: chloramphenicol & gentamycin
  • 57. ANTIBIOTIC AND STEROID COMBINATION  Indication: to reduce the inflammation and itching associated with ear infection.  E.g: pramoxine, benzalkonium chloride,
  • 58. WAX EMULSIFIER  To soften the ear wax / cerumen.  Contraindication: -Otitis external -Dermatitis -Perforated ear drum  E.g: Carbamide peroxide.
  • 59. EQUIPMENT  Tray  Cotton buds  Sterile galipot  Normal saline  Ear drop as prescribe  Receiver (kidney dish)  MOAR  Cotton ball
  • 60. TECHNIQUE > Adult - Pull upward and backward. > Child - Pull downward and backward..
  • 61. IMPLEMENTATION 1. Greet and explain clearly about the procedure to the client. - Purpose of instillation 2. Ask for client’s name and date of birth, compare with client’s ID tag. 3. Check doctor’s prescription. - Choose correct ear drop and check with the prescription.
  • 62. Con’t… 4. Position the client lie in the bed on unaffected ear. 5. Clean the ear using swab sticks moistened with normal saline. 6. Check ear drop medication with 8 R.
  • 63. Con’t… 7. Pull ear upward and backward for adult, downward and backward for children. 8. Hold tip of the bottle 1cm directly above meatus. 9. Instill the ear drops.
  • 64. Con’t… 10. Apply tragus pressure lightly. 11. Make sure client still in this position at least 3-5 minute. 12. Clean the equipment. 13. Document administration of medication.