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Introduces self
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0
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1
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Confirms name and age/DOB of patient
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1
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Explains & gains consent. Asks if patient is in any pain.
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1
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Ask about the nature of the hearing loss (ear, duration, onset)
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1
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Characterises hearing loss (pitch, severity, impact)
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1
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Asks for associated symptoms (tinnitus, vertigo)
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1
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Asks about past medical history of ear infections, head trauma,
surgery
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1
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Takes drug history specifically asking about strong antibiotics in hospital, diuretics, NSAIDs
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1
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Takes occupational history and asks about exposure to loud noises
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1
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Performs gross hearing assessment by whispering in one ear whilst
distracting the other
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1
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Performs Weber's Test
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1
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Performs Rinne's Test
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1
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Inspect Pinna (scars, tags, sinuses and abcesses), the external canal (discharges and eczema) and behind the ear
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1
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Selects correctly sized speculum and attaches to auroscope
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1
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Inserts auroscope safely (right hand for right ear, ulnar border on
cheek, fingers on head)
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1
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Pulls pinna upwards and backwards for adult
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1
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Warns patient before insertion
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1
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Inspects canal for inflammation, foreign bodies or debris
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1
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Examines tympanic membrane (visiblity, colour, shape, light reflex)
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1
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Identifies structures (malleus, pars tensa, pars flaccida, attic)
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1
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Repeats in other ear with new speculum
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1
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Thanks patient
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1
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Washes hands
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1
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Request to do a full neurological exam and tympanometry if
appropriate
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1
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Summarises appropriately with only key findings
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1
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Offers appropriate differential diagnoses
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1
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Patient global score
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0
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1
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2
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