sanguinemare

August 3, 2017

Ear irrigation and Dix-Hallpike Maneuver and Updates

Today was an interesting day!  Surprisingly mostly because of clinic rather than what’s been going on in the in-patient setting.   So much a bit of background – I’ve switched over to the VA for the month on a different team, and we go to clinic once a week as well to experience what things are like at the outpatient setting.  The first time last week was a little hectic – my preceptor had just come back from a week of vacation and had a lot of catching up to do, so it was a bit of a whirlwind.

Today at clinic though, I actually felt like I was able to participate in the healthcare a bit, which was nice – I am starting to realize I would like to be able to do procedures/work with my hands at least a little with the patients.  Currently in the in-patient setting, I feel like my role has mostly just been talking to people (either patients, other team members, or making phone calls) and looking things up on the internet, but it’s mostly theoretical/medical management, and not as much hands-on.  But today during a routine check-up at the clinic, I got to help out with an ear irrigation due to earwax plugging up of ears leading to decreased hearing (and the patient was actually more comfortable when I did it I think), which was something I’d always heard about but never saw in real life.  Basically, she added drops into one ear (5-10) to soften the wax, then plugged it up with cotton and turned the head over to repeat on the other side.  Then they prepared a spray bottle with lukewarm water, attaching a small, flexible tubing to the end, and then removed the cotton, put the tubing into the ear, and gently spray into the ear until the earwax/dissolved debris runs out (don’t forget to put towels below and use a container to catch the water!).  Also don’t spray too hard, or it’ll 1) be painful for the patient and 2) it’ll spray all over you when it comes back out!

I also finally got to see how to do the Dix-Hallpike maneuver in person!  The latter was pretty exciting to me (even though the move actually turned out to be quite simple) because I’d had a patient with unexplained vertigo last month at the hospital that I thought might have BPPV, but since I didn’t know how to do it and no one on my team had done it before either, I wasn’t sure if I should try it, especially since she was so dizzy at baseline.  But now I know!  Essentially the person sits on the bed, turns their torso to a 45 degree angle, and they are supported down to the bed straight down in that manner (without turning their torso back to a supine position), to see whether they get dizzy.  As an aside, I did end up trying the Epley maneuver on that previous patient to try to improve her symptoms, but it was hard to tell which side was worse for her, and I don’t think it did anything much but make her more dizzy… :\  The one thing that did seem to help though, was talking to her and listening to her – she’d had a lot of really sad things happen to her children/family over the last few months, including deaths, stroke, diagnoses of cancer etc, and so talking with her and praying with her on the last day of her stay I think did much better than anything else we’d done for her during her stay.  I’m grateful I had that opportunity.  May God watch over and comfort that family.

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