The AAP guidelines requirements for diagnosing AOM include
recent, abrupt onset of ME inflammation and effusion. MEE confirmed by bulging TM. ME inflammation by distinct erythema of TM or onset of ear pain
Acute onset of bleeding from the ear is usually associated with
Acute onset of bleeding from the ear is usually associated with
Altered mobility of a TM in pneumatic otoscopy may suggest
MEE or possible perforation
AOM treated initially with Amoxicillin with treatment failure and without pcn allergy would next be treated with
AOM treated initially with Amoxicillin with treatment failure and without pcn allergy would next be treated with
The Auditory brainstem response is useful in identifying hearing loss in young infants or children who are
unable to cooperate with EOAE, occasionally sedation is required
The Auditory brainstem response measures signals in the cochlea and
the functioning of the peripheral auditory system and neurological pathways related to hearing, requires audiologist
Azithromycin dose for AOM is:
10mg/kg/day on day 1 then 5mg/kg/day on day 2-5 given daily
A child has been treated with amoxicillin in the previous 30 days for AOM already. The child returns with AOM and concurrent conjunctivitis. The provider will prescribe next
amoxicillin/clavulunate or third-generation cephalosporin
A child returns with AOM, has failed amoxicillin/clavulanate and is now vomiting. The prescriber will prescribe next
ceftriaxone IM
Clinical findings of chronic OM, malodorous purulent discharge, vertigo, a pearly white lesion on or behind TM are findings of
cholesteatoma, and immediate referral for surgical excision is in order
The definition of AOM include
rapid onset otalgia, MEE confirmed and middle ear inflammation
The diagnosis of OME is made when there is evidence of
MEE without s/sx of acute ear infection
Education to parents on installation of ear drops include
the drops should be warmed, the tragus should be pumped a few times after instillation, affected ear should remain up for at least 2-3 minutes
The evoked otoacoustic emissioin (EOAE) testing is the method of hearing screening used for universal newborn screening. The exam provides evidence that hearing is intact however may not identify
auditory nerve dysfunction
The first-line antibiotic for AOM remains
amoxicillin 80-90mg/kg/day BID unless allergy
The following findings are seen with OE examination
pain, often severe with movement of the tragus or pinna, swollen EAC with debris, red crusty or pustular lesions, puritis with thick otorrhea
pain, often severe with movement of the tragus or pinna, swollen EAC with debris, red crusty or pustular lesions, puritis with thick otorrhea
recurrent AOM three times in 6 months or four times in 1 year with at least 1 episode in the last 6 months
Initial treatment for AOM with pcn allergy was treated with Cefdinir, after failure of treatment the next approach would be
ceftriaxone
A Macrolide such as Azithromycin or Cefdinir may be used for AOM if
patient has a PCN allergy.
The major tenants of the guideline for appropriate diagnosis and treatment of AOM are
accurate dx, pain management and initial observation
Mom asks if the patient with a TM perforation if surgery will be necessary
the provider advises that the goal of therapy is management of drainage and watchful waiting. most ruptures complete heal within one month
Mom asks the provider if the patient with pressure-equalizing tubes needs to wear ear plugs while bathing, showering or surface swimming. The providers response is
earplugs should be worn if the child is diving or dunking the head below water level
Mom brings in a 6 y/o patient who previously had AOM, mom states patient no longer experiencing pain however is having profuse drainage. Next the provider would
examine the ear for poss TM rupture
Observation of “watchful waiting” is done for
48-72hrs with phone call f/u, scheduled f/u and poss provide rx
