Preparation

Before you begin an examination it is vital you come prepared. Having the correct equipment readily available saves time and enables you to conduct a thorough examination.

The equipment required includes:

  • Otoscope
  • Speculum or otoscope tip (remember to check the size)
  • Tuning fork (512Hz)

Make sure you check the light on the otoscope before you start the examination. If you look in the ear and it apears dark it is probably because the light is not working! Familiarise yourself with the otoscope before using it. There are a variety of manufactured otoscopes available at the university and they all work slightly differently. You do not want to be in a timed OSCE station trying to figure out how to turn on the otoscope.

The speculums or otoscope tips are available in 2 sizes. There is a 4mm tip which is mostly used on adult patients and a smaller tip that is used on children. The wider the tip the more you can see, so try to use the biggest tip that can fit in the ear canal. This will improve your visibility of the tympanic membrane.

Having the correct tuning fork is extremely important. A 512Hz tuning fork gives the highest frequency and is used specifically to test the hearing. However, a 256Hz can also be used if this is not available. Other tuning forks such as the 128Hz have a lower pitch, which is used for testing vibration and is not part of the ear examination. In an exam you may be asked to identify the correct tuning fork and then use it to conduct special hearing tests. As a general rule the 512Hz is the smaller of the tuning forks but please take the time to get to know which one is which.