4Infection: Otitis Media An inflammation of the middle ear, usually caused by bacteria, that occurs when fluid builds up behind the eardrum.
5Infection: Otitis Media Three types:Acute otitis media - Parts of the middle ear are infected and swollen and fluid is trapped behind the eardrum.Otitis media with effusion - fluid is trapped behind the eardrum following an ear infection.Chronic otitis media with effusion - fluid remains in the middle ear for a prolonged period of time or reoccurs after the infection has resolved.
6Infection: Otitis Media 2/3 of all children under the age of one will experience an ear infection.Half of the children experiencing an ear infection will then experience three or more ear infections by the age of three.
7Infection: Otitis Media Eustachian tubes connect the middle ear to the nose. In children, the Eustachian tube is smaller, shorter and straighter than in adults. This makes it easier for drainage from the eyes, throat or nose to enter the middle ear. Any swelling or fluid from colds, upper respiratory infections, a sore throat or enlarged adenoids can impair or prevent fluid drainage, creating an environment for viral or bacterial infections.
8Infection: Otitis Media Manifestations Ear Pain,esp when recliningIrritabilityAnorexiaEar DrainageFeverChillsMalaisePulling on EarTinnitusImpaired balanceHearing LossDifficulty SleepingNausea, vomiting, or diarrhea
9Infection: Otitis Media Medical Interventions:80% of all ear infections will improve without antibioticsObserve for hours - if condition does not improve or worsens – antibiotics (they can cause vomiting, diarrhea, allergic reaction)Acetaminophen or Ibuprofen for painEar Drops - antipyrine-benzocaine- glycerin (Aurodex)
10Infection: Otitis Media Three ear infections in six months or four infections in a year with at least one occurring in the past six months — or otitis media with effusion — meets criteria for surgical interventionsSurgical Interventions:Myringotomy – a tiny hole in the eardrum that enables the surgeon to suction fluids out of the middle ear.Tympanostomy – a miniscule tube is placed in the tympanic opening to help ventilate and prevent the accumulation of more fluids in the middle ear.Adenoidectomy – removal of adenoids
11Infection: Otitis Media Post myringotomy: It is normal for the tubes to drain fluid for 3-4 days after surgery. Call doctor if fluid is noted after it has stopped.The tubes should remain in place for several months. They will eventually fall out or will be removed by the physician in his office.Antibiotic ear drops may be ordered to be placed directly into the ear.It is imperative that water and fluids are not allowed to enter the ear. If allowed to enter pain and infection can occur. Ear plugs, bathing caps, etc. may be used for prevention.Call doctor if yellow or green fluid is draining from the ear or if fever is present.
12Infection: Otitis Media EducationAnything that blocks, causes swelling or fluid accumulation in the Eustachian tubes can lead to otitis media.Avoid passive smokeLimit exposure to other children with colds or allergies (esp. vulnerable if in day care)Avoid the reclining position when bottle feedingAvoid possible environmental allergensPoverty can lead to unavoidable exposure to multiple factors that can lead to otitis media.
13Infection: Otitis Media Prevention Institute measures to help protect the immature immune system of young children and help prevent otitis media.Utilize good handwashingBreastfeed for at least 6 months-increases immunityObtain immunizationsXylitol (eat or chew) – a natural sugar in some gums and candies that inhibits growth of bacteria
15Infection: Conjunctivitis Conjunctivitis (pink eye) - an inflammation or infection of the conjunctivaOne of the most common and treatable eye conditions in children and adults.Gives the eye a pink or reddish color.May affect one or both eyesSome forms are very contagiousConjunctiva - the transparent thin layer of tissue that covers the inner eyelid and the white part of the eye.Tears contain proteins and antibodies that kill bacteria. Tears help protect the conjunctiva by washing away bacteria.Often begins in one eye and then infects the other eye
16Infection: Conjunctivitis Diagnosed from patient history and signs and symptomsPatient history:Runny noseColdRespiratory infectionSore throatSpread through direct hand-to-eye contact and by large respiratory tract droplets.
17Infection: Conjunctivitis Signs and SymptomsRedness or swelling of the eyeExcessive tearingSwollen eyelidsWhite, yellow or green dischargeItching or burning sensationIncreased sensitivity to lightBlurred visionGritty feeling in the eyeCrusting of eyelids or lashesEye pain
19Infection: Conjunctivitis ViralMost common causeProduces a watery dischargeVery contagiousUsually lasts 7–14 days, but may last 2-3 weeksAdenoviruses - Most common causative organismNo longer contagious once tearing and matting has resolved
20Infection: Conjunctivitis Viral - InterventionsNo specific treatmentWarm compressesAntiviral medication – if caused by viruses such as herpes simplex or varicella-zosterTopical steroid drops
21Infection: Conjunctivitis BacterialHas thicker usually yellow-green dischargeVery contagiousMore common in children than in adultsOccurs less often in children over the age of 5.
23Infection: Conjunctivitis InterventionsWarm or cool compressesAntibiotic eye drops or ointmentsAcetaminophen or Ibuprofen for pain
24Infection: Conjunctivitis AllergicCommon Allergens & Irritants Pollen from trees, plants, grasses, and weedsDust mitesAnimal danderMoldsContact lenses and lens solutionCosmeticsSwimming pool chlorineSmogMedicationsPossible AllergensPollen from trees, plants, grasses, and weedsDust mitesAnimal danderMoldsContact lenses and lens solutionCosmetics
25Conjunctivitis Improves when the allergen is removed Cool compresses AllergicImproves when the allergen is removedInterventionsCool compressesArtificial tearsNon-steroidal anti-inflammatory medicationsAntihistamines/Allergy medicationsTopical antihistamineVasoconstrictor eye drops
26Infection: Conjunctivitis NeonatalResults from:IrritantsBlocked tear ductInfection - Ophthalmia Neonatorum - a severe form that occurs as a result of exposure to sexually transmitted infections (esp. Chlamydia or gonorrhea) while passing through the birth canal.May lead to permanent eye damage unless treated immediately.
27Infection: Conjunctivitis Education/PreventionDon't touch your eyes with your hands.Wash your hands often.Use a clean towel and washcloth daily.Don't share towels or washcloths.Change your pillowcases often.Throw away your eye cosmetics, such as mascara.Don't share eye cosmetics or personal eye care items.Replace eye cosmetics regularly.Wash pillowcases, sheets, washcloths, and towels in hot water and detergentStop wearing contact lenses while infectedUse new disposable contacts or extremely clean hard contacts once infection has cleared.