It is the end of week 4 of my pediatric rotation and I have to be honest... I am just now getting better at correctly diagnosing pedi ears. It is harder than it looks. I used to work in peds in my pre-PA life and think that I am pretty good at building a rapport with the lil ones - but even with all of my experience - it ain't easy. Some kids just hate things in their ears and some kids have so much wax that seeing the TM is impossible (ceruminosis)!
I've had to pull out the big guns several times during my rotation to complete the exam:
I've taken part in bribery - "Yes, you can have 4 stickers if I can look in both ears." I've been a part of the 3-person restraint team for an ear cleaning on a suspected otitis media. I have even sacrificed my own ears so that the kids can do it on me to show that it doesn't hurt. Sometimes you just have to get creative...
I came across this great little magic trick to do an ENT pediatric exam in 45 sec on another blog. Check out the video. I haven't tried it yet, but I will on my next uncooperative lil one.
Source: Academic Life in Emergency Medicine Blog
Ha! Yes, I think it is all part of our rites of passage.
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