When giving ophthalmic drops, hand cleanliness should be emphasized. It is one of the most important strategies of preventing nosocomial infections in the eye care practice setting, so it should be the initial step in the instillation of eye drops. The hypothesis is supported by the nature of the eyes, which are extremely prone to infections caused by gram-negative bacilli, fungi, and adenoviruses (Stevens, 2008). Another evidence-based reason to practice hand cleanliness is that the majority of eye infections are spread through manual contacts. According to the viewpoints, sanitary state is not only the responsibility of ophthalmic experts, but also of family members who participate in the caregiving process. The need for educating relatives who may take part in the instillation of the eye drops is supported by the epidemiological of eye infections. For instance, while it has remained a major public health concern, conjunctivitis is easily controlled through the use of hand washing. Similarity, Neisseria gonorrhoeae and Chlamydia trachomatis can be transmitted through eyes, making Gonococcal and Chlamydial eye infections concerns in the administration of eye drops (Cronau, Kankanala, & Mauger, 2010).
While washing hands eliminate the majority of the public health issues, there is a need for observing the type of soaps used. Unlike other medical events where alcohol-based rubs are used in sanitization, the ophthalmic practice uses microbial soaps. An underlying aspect of the use of alcohol-based rubs is that the residual debris, chemical from the rubs and bacterial toxins that remain in hand can result in new infections. Similarly, the use of non-microbial soap is discouraged, as such soaps are harbingers of gram-negative bacteria.
SJ Case Study
Data that Support Diagnosis of AOM and the Need for Differential Diagnosis
The most pronounced aspect of AOM is that the child is in otitis-prone years. While the infection can affect any subset of the population, under-2s are the most susceptible group. The age is a differential aspect in the diagnosis of the AOM, as the symptoms being experienced are classic to the group. Signs such as tugging ears, restlessness during the night, irritability, high fever, inattentiveness, and loss of appetite are also positive confirmation of the collapsed ear drum (Worrall, 2007). Despite the data that positively identifies AOM, erythematous developments in the tympanic membrane (TM) is inconclusive as the symptom is also shared with other infections of the ear such as Cholesteatoma, Mastoiditis, and Myringitis, Streptococcal pharyngitis, and Mycoplasmal pneumonia. There is thus the need for pneumatic otoscopy to link the oedematous developments in the TM positively. In the case of AOM, the physical examination shows reddening of the mucosa, which advances to mobility challenges as well as suppuration in the middle ear. The bulging in the right TM is also a common sign, where the membrane bulges in the posterior quadrant while the superficial epithelium appears scalded.
Treatment
The first aspect should be pain management, where Ibuprofen or Acetaminophen may be used. The disease seems to be at its initial stage and thus manageable using antibiotics. Amoxicillin should be the first-line drug not only because of its effectiveness but also cost-consciousness. The physical examination confirms tympanic membrane perforation, and thus the need for topical antibiotic drops to not only help the ear drum in regaining its functionalities but also reversing the scarring that has occurred.
Cautions/Instructions to the Mother
The most important message to the mother is to comply with the immunization schedules, as receiving the annual influenza jab and the pneumococcal vaccine shots prevent infections of the middle ear, including otitis media (Worrall, 2007). The mother should also ensure that the child is not exposed to tobacco smoke as the environment risk factor significantly aggravates susceptibility.
References
Cronau, H., Kankanala, R. R., & Mauger, T. (2010). Diagnosis and management of red eye in primary care. Am Fam Physician, 81(2), 137-44.
Stevens, S. (2008). Reducing the risk of infection: hand washing technique. Community Eye Health, 21(65), 17.
Worrall, G. (2007). Acute otitis media. Canadian Family Physician, 53(12), 2147.
