All paramedics will eventually be called to treat a person with a bug in their ear. At first you may ask yourself why this is a paramedic’s problem? But the reality is, if a bug manages to fly directly into a person’s ear it can be very confronting for the patient and if you do not deal with the situation calmly and efficiently you may have a very emotionally distressed patient on your hands.
It is also important to acknowledge how painful and uncomfortable an alive bug crawling or frantically flapping its wings in the deep inner aspect of your ear may be for a patient. In reality, you do not know what type of bug it may be. There is nothing to say that it is not an ant, wasp or spider that is repeatedly stinging or biting the patient from within their head! Also, because the bug is so close the ear drum, any sound that it makes is magnified to the sensitive audio receptors within the ear drum.
How to Safely Remove a Bug in an Ear
As paramedics, with the exception of an extended care paramedic, we do not routinely carry an otoscope, so it is very difficult for us to safely remove a bug from a patient’s ear without potentially damaging the vulnerable ear drum. This does not mean that we can’t start to treat a patient with a bug in their ear.
Working as a paramedic in Australia it is not uncommon to be called to treat a person with a bug in their ear. These are the steps that I use to safely remove a bug from a person’s ear:
1. Reassure the patient that you are aware how distressing this is for them and that you will get the bug out of their ear. The need for confident reassurance cannot be overstated here. These people will be distraught.
2. Lie the patient on the stretcher with their head tilted on the opposite side to the one with the bug in the ear.
3. Pour olive oil into the person’s inner ear, while pulling the lower lobe out to allow maximum fluid into the inner ear. Olive oil is safe for consumption and does not irritate the inner areas of the ear. Olive oil should be at room temperature or slightly warmer. Cold olive oil will generally upset the balance within the middle ear and cause the person to experience vertigo. This may happen anyway, so it is important to let the patient know about this beforehand.
4. Do not let the patient move for 5 minutes. During this time the insect will usually drown. Olive oil is slippery and the bug will not be able to naturally climb out of the ear canal. If the patient can feel the bug moving wait until they feel it stop.
5. After 5 minutes (or until the bug stops moving) turn the patient over to the other side and let the olive oil and bug drain freely out of the ear. Use a cotton ball to remove the bug from the outer ear and any remaining olive oil. If the bug does not come out or the patient is still very uncomfortable and believes there is something still in the ear, transport the patient to hospital.
Warning Tips When Removing a Bug in an Ear
These are some important warning tips about removing a bug from an ear:
1. Don’t put anything inside the ear canal – you can easily damage the soft tissues of the ear drum and cause damage. Make sure the patient doesn’t have anything that he or she can use to jam into their ear as this will cause damage to the inner ear.
2. If the patient is in pain do not wait on scene with the patient to try and remove the bug. Place them on a stretcher and pour olive oil into the ear canal and then transport.
How does a bug get into a person’s ear? A bug can simply fly, fall or crawl into a person’s ear while they are outside, inside asleep or awake. During certain times of the year bugs are more plentiful and active.