Where to next?
In older children and adults:
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​earache
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hearing loss
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discharge
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itching/irritation
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high temperature (≥38°C)
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In younger children:
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rubbing/pulling of ear
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irritable/restless
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balance issues
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Otoscopic examination findings:
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Red, yellow, or cloudy tympanic membrane
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Moderate to severe bulging of tympanic membrane, loss of normal landmarks, airfluid level behind the tympanic membrane
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Tympanic membrane perforation and/or sticky discharge in the external auditory canal
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Infected tympanic membrane, viewed with an endoscope inserted into the external auditory canal
References
Refer to GP if any of the following:
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Patient is systemically very unwell
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Patient has signs of a more serious illness
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Patient is high risk of complications because of pre-existing comorbidity (this includes children with significant heart, lung, renal, liver or neuromuscular disease, immunosuppression, cystic fibrosis and young children who were born prematurely)