a. Describe the irrigation procedure to the person who will be treated with the removal manoeuvre and invite him/her to take a seat.
b. Place a container under the ear to be treated to collect the excess of irrigation, mixture of ear wax and water, and place a towel or gown on the shoulder to prevent streaking. Provide the patient with a small towel, or blotting paper in order to dry at any time.
c. Despite the fact that direct viewing is not essential for a safe and effective irrigation, check the ear canal in order to direct the flow of water properly before using the Lantitaps.
d. Gently pull the patient’s pinna upwards and backwards in adults or downwards and backwards in children, to line up the ear canal bends in order to make the entry of irrigated water and the output of the waste easier. It is recommended to use the first and second finger of the opposite hand of the ear to be irrigated, that is, if the patient’s left ear is to be irrigated use the right hand to pull, and vice versa.
e. Take the Lantitaps with the other hand and introduce its tip, the interchangeable speculum, no more than a third of the ear canal (<8 mm generally).
f. It is recommended to rest the front of the Lantitaps on the third finger of the same hand which pulls from the pinna, to stop it and to avoid the device to be introduced excessively in the ear canal during the irrigation.
g. Point the speculum to the ear wax contact zone in the back of the upper ear canal, in order to make sure that the flow of water will not directly collide against the tympanic membrane reducing, thus, the risk of its rupture.
h. Hold the Lantitaps in a fixed position and push the trigger to activate the exit of water (Figure 6). The trigger can remain pushed until the Lantitaps reservoir is completely emptied or it can be released to stop the exit of water. By doing so, more water flow in the ear canal will be avoided when appropriate, as in changing the direction, etc.
i. Any discomfort experienced by the patient during the irrigation should immediately interrupt the irrigation.
j. After each irrigation, view the ear canal to check the state of it and whether another irrigation with the Lantitaps is necessary.
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