There's a what in your what?

[Tincanfireman]

Got dispatched from my nice warm rack at 0340 the other morning for a "patient in pain". Trying to come up with a good reason short of amputation to get me up at that hour, we went to the truck and got moving (I know, it's my job, it is what I get paid to do, etc. Fine; I'm a grouch at that hour...lol) We arrive to the patient walking out of the house to meet us at the curb, so my BS flag is already way high. "Guys, I'm so sorry to call you, but I have a ...OW OW OWWWWWW... bug in my ear!" Since it was my ride (sigh), I got the guy in the back and sat him down to have a look. "Oh, you can't OW OWWWW see it" sez he. Figuring he was either a psych case or was really hurting, there was little I could do in the back of the rig, so we get enroute. In between apologies and his Tourettes-like outbursts, I learned they had sprayed for bugs that afternoon and he had been awakened by the alleged bug scurrying off the pillow and into his ear canal. Still, I was beginning to believe the guy, to the point that I successfully convinced the ER staff to put him in a room (instead of triage) when we arrived at the hospital. I stayed with him until the nurse arrived with a cheery "so what's going on tonight?" When I told her his C/C, she paused only ever so briefly, then grabbed the otoscope and said "well, only one way to find out." I knew my reputation was gonna take a serious hit if he had been bluffing, but then I heard the nurse say "I'll be darned, look at him!" She told me my guy had a 3/4" roach right up against his eardrum, and every time he moved Mr. Critter was banging away at the tympanic membrane. Very quickly the doc arrived, assassinated the critter with H2O2 and pulled him out of the guy's head. I found out later that I was the newest member of a fairly exclusive club, in that everyone had heard of these cases, but few had actually seen one. In the end, my gut instinct had been proven correct, and he was actually a very decent fellow, and very grateful for the care and transportation we had provided him along with my successful advocacy. He ended up being discharged before I was able to complete all the paperwork!

 

[reaper]

Had a girl with a 1/2 roach in her ear. I could see it move around , but couldn't get it out. Doc hit it with lido and pulled it out.

Makes me want to wear earmuffs when I sleep!!

 

[Airwaygoddess]

Bugs! Bugs! Bugs!!!

YUCKY!!!!!!! I would think it's even worse to find half of a cockroach!!! Airwaygoddess is creeped out!

 

[flhtci01]

Recently watched a Tales of the ER where they pulled a 1" beetle out of a guys ear. The video of the bug in the ear canal was neat.B)

 

[jochi1543]

EWWWWWW!:wacko:

 

[fortsmithman]

Wear hearing protectors.

 

[marineman]

Thank god all those nasty critters don't like the cold up here.

 

[JPINFV]

I WAS a patient in one of these cases. Was playing catch in my front yard earlier in the day about 10 years ago and had the ball go over the fence. Hoped the fence through a few trees and got the ball. Fast forward 3-4 hours when the damn bug started banging away in my ear causing my parents to think I was becoming possesed since I was going absolutely nuts one second, and was perfectly fine the next. Since this was before the time when every minor issue was a 911 call, my dad tried to flush out my ear with a bulb syringe, which brought peace for a few minutes, but failed to exocise the bug. We ended up going down to the local urgent care "doc in a box" office a few blocks away where he was able to power wash my ear with a syringe after taking the time to show my dad (who was -ever so impressed-) the bug with the ottoscope.


As an aside, cases like this (is this person REALLY crazy?) is why I recommend the book The Man Who Mistook His Wife For A Hat: And Other Clinical Tales by Olive Sacks as a must read. There are plenty of neuological conditions that makes a person seem crazy (like essentially losing vision on one side of their field of view, but the patient thinking they have a normal field of vision) when there's a perfectly reasonable non-psychiatric explanation of their symptoms.


As an additional question, would it be unreasonable as a prehospital provider (because parents and patients self treating is completely different than a medical professional providing treatment) to flush a patient's ear ourself?

 

[traumateam1]

I WAS a patient in one of these cases. Was playing catch in my front yard earlier in the day about 10 years ago and had the ball go over the fence. Hoped the fence through a few trees and got the ball. Fast forward 3-4 hours when the damn bug started banging away in my ear causing my parents to think I was becoming possesed since I was going absolutely nuts one second, and was perfectly fine the next. Since this was before the time when every minor issue was a 911 call, my dad tried to flush out my ear with a bulb syringe, which brought peace for a few minutes, but failed to exocise the bug. We ended up going down to the local urgent care "doc in a box" office a few blocks away where he was able to power wash my ear with a syringe after taking the time to show my dad (who was -ever so impressed-) the bug with the ottoscope.


As an aside, cases like this (is this person REALLY crazy?) is why I recommend the book The Man Who Mistook His Wife For A Hat: And Other Clinical Tales by Olive Sacks as a must read. There are plenty of neuological conditions that makes a person seem crazy (like essentially losing vision on one side of their field of view, but the patient thinking they have a normal field of vision) when there's a perfectly reasonable non-psychiatric explanation of their symptoms.


As an additional question, would it be unreasonable as a prehospital provider (because parents and patients self treating is completely different than a medical professional providing treatment) to flush a patient's ear ourself?

I don't think it is. Shoot some NS into the p/t's ear if they have a C/C of a bug being in there. If you don't get it out, well than fine, ERs problem.. However if you do get it out, sweet.

 

[Buzz]

Recently watched a Tales of the ER where they pulled a 1" beetle out of a guys ear. The video of the bug in the ear canal was neat.B)

Saw that one too... A june bug is a seriously large bug to get inside your ear though...

 

[medicdan]

As an aside, cases like this (is this person REALLY crazy?) is why I recommend the book The Man Who Mistook His Wife For A Hat: And Other Clinical Tales by Oliver Sacks as a must read. There are plenty of neuological conditions that makes a person seem crazy (like essentially losing vision on one side of their field of view, but the patient thinking they have a normal field of vision) when there's a perfectly reasonable non-psychiatric explanation of their symptoms.

Quick side note:
The book you cite is EXCELLENT-- some fascinating stories written by an excellent doctor.
If you like Dr. Sacks, consider reading Phantoms in the Brain: Probing the Mysteries of the Human Mind by Dr. V. S. Ramachandran (no, I could not spell that without help). Dr. Atul Gawande (and his several books) are also highly recommended.

[/rant]

 

[Sasha]

I was told by my instructor that if you have a bug in the ear, turn off all the lights and draw it out with a pen light, according to him when theyre trapped and have no where to go, theyll scurry too the light instead of away.

If the guy had been MY patient, he woulda gotten a 4x4 over said ear and a speedy trip to the hospital. Im terrified of roaches, spiders, and other creeper crawlies.

 

[EMTinNEPA]

Im terrified of roaches, spiders, and other creeper crawlies.

So bugs are horrifying but doing battle with the angel of death every day is no biggie? ^_^

 

[Sasha]

So bugs are horrifying but doing battle with the angel of death every day is no biggie? ^_^

The Angel of Death doesnt have feelers and six legs! That just aint natural!

 

[sixmaybemore]

Recently watched a Tales of the ER where they pulled a 1" beetle out of a guys ear. The video of the bug in the ear canal was neat.B)

Was that the one where it was a waitress, and she was going ballistic with the junebug in her ear?

(hey, what can I say, I couldn't sleep and that was all that was on!)

 

[flhtci01]

Was that the one where it was a waitress, and she was going ballistic with the junebug in her ear?

(hey, what can I say, I couldn't sleep and that was all that was on!)

That was the one. It was either that or infomercials at that time of the night.

 

[sixmaybemore]

That was a sincerely big bug. Made me want to sleep with earmuffs on lol.

 

[MJordan2121]

When I was a child, I ended up having a tick in my ear. Now I am totally freaked out and will be sleeping with ear muffs on for the rest of my life.

 

[apagea99]

There's a statistic somewhere that tells how many spiders the average person ingests in their sleep per year.....I think I read it in one of those bathroom readers. True or not, it's creepy......and a little crunchy I'd say :unsure:

 

[MRE]

If the guy had been MY patient, he woulda gotten a 4x4 over said ear and a speedy trip to the hospital. Im terrified of roaches, spiders, and other creeper crawlies.

I wouldn't do anything to keep the bug in the ear. Last thing you want is for it to decide it can't go back out and start trying to dig through the ear drum.

I figure if its not causing a problem, just transport. If it is causing a problem, have the patient lay on their side with the ear that has the bug facing the ceiling, then slowly drip NS into the ear, hopefully when the ear canal floods the bug will make its way to the outside to be collected and taken to the hospital.