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module menu icon Acute otitis media

ACUTE OTITIS MEDIA

ELIGIBILITY:1 For children aged 1 to 17 years

EXCLUDE: Recurrent acute otitis media (3 or more episodes in 6 months or 4 or more episodes in 12 months), pregnant individuals under 16 years

ACUTE OTITIS MEDIA (AOM) is defined as the presence of inflammation (redness and swelling) in the middle ear, associated with a build-up of fluid behind the ear drum which presents with signs and symptoms of an ear infection.10 AOM is most common in children aged between 0-4 years and is usually caused by viruses like colds and flu.10,11 In 60% of cases, children suffering with AOM start to improve within 24 hours without antibiotic treatment, and most people recover within 3 days.10,11 Those suffering with a bacterial infection may be eligible for the Pharmacy First service.

A dad and his 1-year-old daughter Sienna approach you at the pharmacy counter. Sienna looks upset and is tugging her right ear. He tells you that she has not been herself lately; she has been crying, not feeding well, and has been indicating pain in her ear, so he called 111 as he was concerned. They advised him to visit this pharmacy where the pharmacist should be able to assess Sienna through the Pharmacy First service.

You inform the pharmacist, who has been expecting Sienna, and they are led to the consultation room.

While they are in the consultation room you consider the signs and symptoms she presented with and if she had any red flag symptoms.

1. SIGNS & SYMPTOMS
2. RED FLAGS

Sienna appears with some of the signs and symptoms of AOM:1,11

  • Earache

  • Fever

  • Nausea

  • Lack of energy

  • Slight hearing loss


As a young child, Sienna also shows the following:11

  • Rubbing or tugging her ear

  • Not reacting to sounds

  • Irritable and restless

  • Losing her appetite

  • Losing her balance

Sienna does not appear to have any red flag symptoms:1,11

  • Signs of a serious illness, e.g. meningitis or sepsis

  • Severe pain

  • Regular ear infections

  • Headache

  • Nausea and vomiting

  • Photophobia

  • Mottled skin

Click the button to find out whether this customer is eligible for referral.

REFERRAL OUTCOME

Referred to the Pharmacy First service

A short while later, they leave the consultation room and dad has been given some antibiotics for Sienna. The pharmacist asks you to offer them some self-care advice, some prevention tips and some OTC products for symptom relief that they can use in conjunction with the treatment.

PREVENTION TIPS

You tell dad that: “You can’t always prevent ear infections, particularly inner ear infections caused by colds and flu; however, there are some things you can try:”10,11

  • Make sure Sienna is up to date with vaccinations

  • Keep her away from smoky environments

  • Avoid giving her a dummy as she is older than 6 months

  • Avoid feeding her while she is lying flat on her back

SELF-CARE ADVICE & PRODUCT RECOMMENDATIONS

Dad should adhere to the following advice to aid Sienna’s recovery:10,11

  • Paracetamol or ibuprofen can be used to relieve the pain and fever – it’s important to read the dosage instructions carefully and check suitability with the pharmacist

  • Place a warm cloth over the affected ear – this can help to relieve pain

  • Remove any discharge by wiping the ear with cotton wool

  • Once her earache and fever has settled she should be able to return to nursery

Complete the care

Dad purchases some ibuprofen suspension. You advise him about the correct dosage according to Sienna's age and weight and remind him how to administer and store her antibiotics. You reassure him that ear infections are very common in young children and she will likely improve with her treatment. If he has any more questions, he can come back for more advice.

KEY LEARNING POINT

It’s important to remember the differences when offering advice and products to adults and children. Product advice and self-care recommendations are often based on the child’s age and weight, amongst other factors. It is important to offer personalised, relevant advice to parents, who are often quite worried and need reassurance.

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