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Emergency Department Discharge Instructions

Ear infection - inner ear/otitis media



Emergency Care Discharge Instructions

Instruction summary

This type of infection is usually caused by bacteria growing inside the inner ear canal. The inner ear is drained by a tube that leads from the ear to the back of the throat. When we get a cold or a viral infection, this tube can become blocked off (due to inflammation and swelling of the tube), drainage can’t occur properly, and this creates an environment for bacteria to grow. Children tend to have more ear infections because their ear tubes are smaller and more horizontal, making them more easily blocked and less able to drain.

If you were prescribed antibiotics, fill the prescription and start the medication as soon as possible. Make sure you take your antibiotics as directed, the whole course (don’t stop early). There should be a significant improvement within two days of taking the antibiotics.

You can take acetaminophen (which is the same thing as Tylenol) or ibuprofen (same thing as Advil or Motrin) for the pain. If the fever hasn’t come down one hour after giving one of these medications, you can try the other medication. While it is very safe to try both, it is important to make sure that you take (or give your child) the right dose of each, as instructed on each box.

Try to avoid taking any flights while there is ongoing pain.

Reasons to return to the ER
  1. Ongoing fever (≥38.0 °C or 100.4 °F) after two days of antibiotics use (as prescribed)
  2. More fluid coming out of the ear
  3. Seizure
  4. Feeling drowsy, confused, or lethargic. Lethargy is an extreme form of tiredness when a person is only minimally responsive. An example of a lethargic child is a child who is lying still and does not make eye contact with you when you speak to them.
  5. Neck stiffness