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In the adult population, I will remove in cases of benign positional 
vertigio and have caught that as the culprit several times. I mix 
hydrogen peroxide and water 50/50, instill in the canal, let sit for 
about 20 minutes and then remove.


Jeff Myers, DO, EdM, EMT-P, FAEMS
Buffalo, NY


On 3/24/2017 4:44 PM, Milton Tenenbein wrote:
> Dear All,
>
> I use a syringe and tap water and am satisfied with this method.
> My indication for cerumen removal is decreased hearing as the primary complaint.
>
> >From time to time I am a victim of this dreaded condition.
> The chief clinical finding is muffled heart sounds (my patients - not my own).
>
> The ENT folks have just published a 29 page clinical practice guideline on the management of cerumen impaction.
> It is supported by 121 references.
> I guess some folks have a lot of time on their hands.
> I have attached it for your reading pleasure - enjoy!
>
> Milton Tenenbein
>
>
> -----Original Message-----
> From: Pediatric Emergency Medicine Discussion List [mailto:[log in to unmask]] On Behalf Of Howard, John
> Sent: Wednesday, March 22, 2017 10:28 PM
> To: [log in to unmask]
> Subject: Cerumen impaction
>
> Hello group:
>
>
> I was curious who uses colace in the PED to assist with cerumen impaction?  The guidelines I've read say 1 ml on affected side, leave cotton in ear, reassess in 20-30 min.
>
> -Do any of you use this?
>
> -If so, do you keep it stocked inside your ED?  (I think waiting for our pharmacy to deliver it to us in the ED would add too much time to an otherwise straight-forward visit.)
>
>
> Thanks for your feedback,
>
>
> John Howard, DO
>
> Advocate Children's Hospital
>
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-- 
Jeff Myers, DO, EdM, EMT-P, FAEMS
Emergency Care Physician and Educator
Buffalo, NY


For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
                 http://listserv.brown.edu/ped-em-l.html