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  • Help needed with Otitis Externa

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    Old 02-18-2011, 06:21 AM   #1
    ran4872000
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    Angry Help needed with Otitis Externa

    I am seeking expert advise for a care plan for one of my patients. I am a remote site medic at a forward operating base in Iraq. I am providing care for the contract(non-military) protective force in the base. I have no direct access to MD's or ENT's at my site. I have a case of Otitis Externa that is not responding to treatment. The patient is a late 40's male with no significant medical history related to the condition. The patient also has no allergies to meds. He was seen by another remote medic starting on July 2010 for ear pain from cleaning his ears with a q-tip. He had redness and swelling to the abrased spot in the canal with a small amount of pus coming from the wound. The treatment then was cortisporin otic. The pt didn't respond to med so cortisporin was continued with Augmentin and Levaquin PO added. After a month, the treatment was not successful. The pt was placed on Bactrim, cortisporin continued and a lavage of the canal done to remove debris and relieve the muffled hearing that had developed. This type of treatment continued off and on until Jan 2011 when Cipro Otic was started. I replaced the previous remote medic and "inherited" the problem at the beginning of Feb. I did a lavage and put him on Amoxil PO. He is not responding.
    I have been studing up on the condition and have conflicting information. Some websites recommend oral steroids, others otic meds only. The pt's contract will end at the end of March and he will be going to the states and seeing his ENT for treatment. My goal is to keep him from perminent damage or sepsis until then. Any possible treatments will be welcomed and I will hold no one to any liability for there suggestions.

     
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