CAUSES Pressure changes Respiratory infection-congestion or sinus infection
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1 Page 1 of 6 pages NOTE Contact Surgeon before giving any medication marked with an asterisk. In an emergency or during Loss of Signal, begin appropriate treatment; then call Surgeon as soon as possible. SYMPTOMS Facial pain Ear pain Tooth pain Congestion CAUSES Pressure changes Respiratory infection-congestion or sinus infection DIAGNOSIS 1. Examine ear with Otoscope (Physical Exam-9). For redness, fluid, bubbles, movement, or perforation 2. Record body temperature: with Oral Disposable Thermometers (P3-A2). 3. Contact Surgeon with results and for treatment recommendations.
2 Page 2 of 6 pages TREATMENT 1. Decongestants DRUG HELP 1. Sudafed has a more rapid onset of effect and is shorter acting than Entex LA. It is a simple and effective decongestant, and may also be used prior to any pressure changes (such as EVA) after consultation with Surgeon. Sudafed s main possible side effects are rapid heart rate and jitteriness. For sinus problems, it is recommended to start with Sudafed, then consult with Surgeon. 2. Afrin Nasal Spray and Galasolin Nasal Drops are topical nasal decongestants and useful for nasal and ear congestion. These are good agents if mildly congested and any pressure changes are anticipated. Use only as needed, and do not use either agent for more than 3 days. 3. Entex LA contains a decongestant and a medication to loosen secretions. Entex LA is longer acting and milder, and is a good choice for mild but persistent symptoms. Afrin Nasal Spray (P2-B1) - Topical nasal decongestant Dose: 1-2 sprays every 12 hours as needed Burning, stinging, dryness, sneezing, or increased nasal discharge Usage more frequently than directed can produce chronic nasal congestion. -2 Galasolin Nasal Drops - Topical nasal decongestant Dose: 1-2 drops in each nostril, 1 to 3 times/day Tachycardia (rapid heart rate greater than 100 beats per minute), increased blood pressure
3 Page 3 of 6 pages Entex LA (Phenylpropanolamine/Guaifenesin) (P1-B14,15) Dose: 1 tablet every 12 hours as needed Insomnia, restlessness, headache, nausea Sudafed (Pseudoephedrine) (P1-B16) Dose: 1-2 tablets every 6 hours as needed May cause high blood pressure and rapid heart rate, restlessness 2. Antibiotics DRUG HELP All of these medications (Amoxil, Ampioks, Biseptol/Bactrim, Duricef, Cipro/Ciprolet, Tarivid, Zithromax) are generally effective for sinus infection, and serious side effects are uncommon. Selection depends on individual experience and known allergies or sensitivities. It is best to check with Surgeon before beginning treatment. Depending on severity, treatment may be extended from 7 to 14 days. NOTE If fever, contact Surgeon for antibiotic choice. Amoxil (Amoxicillin) (P1-A13,14,15) Dose: 1 capsule 3 times/day for 10 to 14 days Do not use if there is history of Penicillin or Cephalosporin allergy. Nausea, diarrhea, rash
4 Page 4 of 6 pages -1 Ampioks (Penicillin/Oxacillin) Dose: 2 capsules 4 to 6 times/day for 7 days Do not use if there is a history of Penicillin allergy. Nausea, vomiting, diarrhea Bispetol (Trimethoprim/Sulfamethoxasole) Dose: 1-2 tablets 2 times/day for 7 days Do not use if allergy to Sulfa or Trimethoprim exists. Give with caution to patients with severe allergy or asthma. Skin rash, headache, stomach upset -OR- -OR- Bactrim DS (Trimethoprim/Sulfamethoxasole) (P1-A4,5) Dose: 1 tablet 2 times/day for 10 to 14 days Do not use if allergy to Sulfa or Trimethoprim exists. Give with caution to patients with severe allergy or asthma. Skin rash, headache, stomach upset, photosensitivity
5 Page 5 of 6 pages Duricef (Cefadroxil) (P1-A18,19) Dose: 1-2 capsule every 12 hours for 10 to 14 days Do not use if there is history of Penicillin or Cephalosporin allergy. Diarrhea, nausea, vomiting, abdominal pain, rash -4 Tarivid (Ofloxacin) Dose: 1 tablet 1 to 2 times/day for 7 days Nausea, vomiting, headhache, dizziness, insomnia, allergic reactions, decreased field of vision -2 -OR- Ciprolet (Ciprofloxacin) Dose: 1 tablet 2 times/day for 7 days Nausea, diarrhea, vomiting, abdominal pain Zithromax (Azithromycin) (P1-B7) Dose: 2 capsules first day followed by 1 capsule 1 time/day for 4 days Diarrhea, nausea, abdominal pain, vomiting
6 Page 6 of 6 pages 3. Pain Medication DRUG HELP 1. Ascriptin (buffered aspirin), is an anti-inflammatory and analgesic agent. It may cause mild upset stomach and should be avoided if there is allergy to aspirin. 2. Tylenol and Analgin are analgesics. Analgin has minimal anti-inflammatory effects and Tylenol has none. They do not cause upset stomach, and work almost as well for general pain as do the anti-inflammatory agents. Selection is based on preference and experience. 3. Ascriptin, Tylenol, and Analgin all help to reduce fever. Ascriptin (Aspirin) (P1-B1,2) - Pain reliever, anti-inflammatory Dose: 1-2 tablets every 4 to 6 hours as needed NOTE Do not use in patients with asthma, history of aspirin allergy, GI, or other bleeding problems. Upset stomach, ringing in ears -1 Analgin - Non-narcotic analgesic agent Dose: 1 tablet 3 times/day Blood clotting defect due to low platelet count Tylenol (Acetaminophen) (P1-A1,2,3) - Aspirin-free pain reliever Dose: 1-2 tablets every 4 to 6 hours as needed Can cause ringing in ears 4. Contact Surgeon and schedule follow-up observation and PMC activities.
Diagnosis AMP Examine ear with Otoscope (Physical Exam-9) and report findings to (blue) Surgeon.
Page 1 of 8 pages NOTE Contact Surgeon before giving any medication marked with an asterisk. In an emergency or during Loss of Signal, begin appropriate treatment; then call Surgeon as soon as possible.
MILD TO MODERATE NOTE Medication is listed in increasing order of strength. Ascriptin (Aspirin) (P1-B1,2) - Pain reliever, anti-inflammatory
Page 1 of 6 pages Contact Surgeon before giving any medication marked with an asterisk. In an emergency or during Loss of Signal, begin appropriate treatment; then call Surgeon as soon as possible. MILD
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