Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
2 min synopsisUK scopeSources checked 7 Sept 2026Clinical review pending
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A normal-looking drum can accompany an emergency
Otoscopy examines the sound-conducting structures that can be seen; it cannot exclude an acute cochlear or neurological cause of hearing loss.
Action: For hearing loss developing over three days or less during the previous 30 days, without an external or middle-ear explanation, arrange ENT or emergency assessment within 24 hours. New facial weakness, severe vertigo with neurological signs, or serious head injury requires the appropriate emergency pathway.
Synopsis
Perform a safe, systematic ear examination, describe tympanic membrane abnormalities precisely, and connect the findings and hearing history to the appropriate next investigation or referral.
Explain the examination and obtain consent, using a communication method that the person can understand.
Inspect the pinna, surrounding skin and mastoid region before placing an instrument in the canal.
Use adequate illumination, a comfortable speculum and a hand position braced against the patient's head.
Key red flags
Sudden unexplained hearing loss needs time-critical referral even when the canal is clear and the tympanic membrane looks normal.
Investigation priorities
01
Structured history and inspection before otoscopyFirst step
Establish urgency, communication needs and procedural risks before instrumentation.
Management branches
Safe examinationObtain the view without causing injury
The patient consents to examination and can maintain a safe position.
Check the light and viewing system, perform hand hygiene and choose a clean, correctly fitted speculum; avoid transferring infection between ears.
Examine the surrounding tissues, then inspect the canal and different membrane regions with gentle changes of angle rather than deep insertion.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 7 Sept 2026; clinical approval remains outstanding.