Ruptured eardrum

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uncfnp

Solo Diver
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Hey guys.

Well we finally got to do a bucket list dive trip to Komodo and Eric has ruptured an eardrum. I know the basics of care, mostly no diving, but I have Ciprofloxacin ear drops with me. Should I start them?

Thank you.
 
I would hold the Cipro drops unless there are signs of external ear infection, and defer to @doctormike for the final opinion. Sorry that happened, and on a bucket list trip no less!
 
Thanks DDM. This morning his ear had pus behind the eardrum and he was complaining of worsening fullness and tinnitus. This afternoon it started draining so I did start him on Augmentin, the Cipro drops and a low dose steroid that I hope might also help his congestion.
 
Ciprofloxacin is approved for a non-intact TM, no harm in using it if the diagnosis isn't clear. My experience with answering ear questions online over 30 years is that the diagnosis is rarely correct. Sometimes, you need a microscope and suction to really examine the ear.

That having been said, treatment for a traumatic, dry perforation is dry ear precautions, no cipro drops needed. If the ear is draining, that suggests a middle ear process. Cipro can help, but if there is heavy drainage, it doesn't really get in.

If you are confident of the diagnosis of a draining perforation, generally systemic antibiotics are not needed initially (sometimes used for chronic drainage). And if you had pus coming out of the ear, no harm in using cipro drops if you have them (even though they may not work that well without cleaning).

Cipro can help, not with the middle ear process, but with the discomfort of the outer ear infection ("Swimmer's ear") that comes with having purulent drainage in the ear canal, so there is that!

And lastly, these are $25 on Amazon... put one in your dive kit, and you can send a pic, so we can help you better remotely next time! Just throw away the ear cleaning attachments...

Bebird R1 Ultra Ear Camera
 
Ciprofloxacin is approved for a non-intact TM, no harm in using it if the diagnosis isn't clear. My experience with answering ear questions online over 30 years is that the diagnosis is rarely correct. Sometimes, you need a microscope and suction to really examine the ear.

That having been said, treatment for a traumatic, dry perforation is dry ear precautions, no cipro drops needed. If the ear is draining, that suggests a middle ear process. Cipro can help, but if there is heavy drainage, it doesn't really get in.

If you are confident of the diagnosis of a draining perforation, generally systemic antibiotics are not needed initially (sometimes used for chronic drainage). And if you had pus coming out of the ear, no harm in using cipro drops if you have them (even though they may not work that well without cleaning).

Cipro can help, not with the middle ear process, but with the discomfort of the outer ear infection ("Swimmer's ear") that comes with having purulent drainage in the ear canal, so there is that!

And lastly, these are $25 on Amazon... put one in your dive kit, and you can send a pic, so we can help you better remotely next time! Just throw away the ear cleaning attachments...

Bebird R1 Ultra Ear Camera
I understand your skepticism but I am 100 percent confident in the diagnosis. The onboard otoscope isn’t much but does the job. The perforation started as a small triangular shaped hole in the posterior quadrant near the umbo.

I am happy to report it looked much improved this morning. No more drainage, redness is much improved and now the tear is just a small round hole.

Thanks everyone for your help.
 
I understand your skepticism but I am 100 percent confident in the diagnosis. The onboard otoscope isn’t much but does the job. The perforation started as a small triangular shaped hole in the posterior quadrant near the umbo.

I am happy to report it looked much improved this morning. No more drainage, redness is much improved and now the tear is just a small round hole.

Thanks everyone for your help.

Sounds good! Glad you were able to get a good look...
 
The onboard otoscope...
I have never heard of this before, and it's interesting. Dive boats routinely carry these in their first aid kits at remote locations?
 
I have never heard of this before, and it's interesting. Dive boats routinely carry these in their first aid kits at remote locations?
I don’t know and was surprised when I was told they had one. Small and plastic similar to ones that sell for about 20 dollars on Amazon but thankfully it did have a small supply of disposable speculums. Looked like maybe one or two might have been missing so it had been used at least once before.
 

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