“The former process of syringing (water jet irrigation into the ear canal to clear ear wax debris) was associated with various post treatment issues including perforation of the tempanic membrane, causing patient morbidity. For this reason the practice was halted,“ Brooking said.
“The latest treatment process is with using direct observational microsuctioning (a vacuum) for wax debris removal. This method is safe, gentle and effective. It is best practice medicine.
“Our staff at the Te Hiku Hauora GP Clinic have started the training programme with Ears Made Easy. As a service we are in the process of sourcing new microsuctioning equipment. I am sure you can appreciate it takes time to master new clinical skills, find the budget for equipment purchase, ensure safe practices and processes are implemented, and staff the new developed service.
“But I am always optimistic and hopeful that we will have this service organised within the next three months, if all goes well. Access to best patient care locally is essential for our community, and is one of my personal philosophies.“
She said until then, Kaitāia Hospital have started an ENT microsuctioning service for the community.
“For Te Hiku Hauora registered GP Clinic patients we are able to facilitate a referral to the ENT nurse specialist service at the hospital. The referral requires physical examination, medical and social history information and patient consent. Each referral is subject to triage for priortisation by the hospital. The referral can be completed by one of our practitioners at a GP clinic appointment,“ Brooking said.
“Change in clinical practice is essential when patients are being harmed. It can take some time to collate data and critically review the information to then influence practice. In this instance, the cessation of the practice of ear syringing was the only correct option for our service. And in due course the establishment of a safer more effective practice with direct observational microsuctioning for the removal of ear wax debris.“
But that’s little comfort to the Fields.
“I’ve been to the hospital and there’s a three-month waiting list for it to be done there, so that’s no good to us, we can’t wait three months. We now have to go to Kerikeri, which means a day out, three hours driving, and the associated petrol costs, and then $65 to have it done. That’s a big expense when you are on a pension,“ Peter Field said.
“And the problem is there’s also awaiting list there so if we can’t get in there, we will have to go to Whangārei it get it done, which will be even more hassle and expense - and probably an overnight stay.“
■ Why Do Ears Make Wax?
Earwax is made in the outer ear canal, the area between the fleshy part of the ear on the outside of the head and the middle ear. The medical term for earwax is cerumen (seh-ROO-mun).
Earwax has some important jobs. It acts as a waterproof lining of the ear canal, protecting it and the eardrum from germs that can cause infection; traps dirt, dust, and other particles, keeping them from injuring or irritating the eardrum
The wax makes its way through the outer ear canal to the opening of the ear. Then it either falls out or comes out during bathing. In most people, the outer ear canal makes earwax all the time, so the canal always has enough wax in it.
Usually, there’s no need to remove earwax because it comes out by itself.