It's been a while since my last blog because I have been busy getting all my academic requirements completed and am happy to report that I am officially done with residency. This story occurred about a month ago.
A 32 year old Hispanic female arrived holding her left ear and screaming at the top of her lungs. She was yelling in Spanish so I didn't know what she was saying. The triage nurse came up to me and told me that she had a live cockroach in her ear. I immediately went into the room and looked. Sure enough, a rather large cockroach was at the very back of her ear by the tympanic membrane (TM). I could see the tentacles moving and it's legs scratching at the membrane. It was the scratching which was causing her distress so I attempted to flush the thing out with some saline. In the process, I would periodically check to see if it had moved. Unfortunately, the roach would simply crawl back up into the ear after each irrigation.
I then put some viscous lidocaine in the ear to help with the pain and to try and kill the roach. Shortly after, I re-checked the ear and noticed that the TM perforated and now had a large hole in it! The roach had crawled into the hole behind her tympanic membrane (in layman's terms....bad shit!!!). At that point, I broke down and called ENT and she went up to the ENT clinic for roach removal. To this day, I don't know what happened in the ENT clinic, but I doubt it was good.
-Doc Sensitive
13 comments:
Holy smokes dude.
that's scary....
now that creeps me out.
That is one of my worst nightmares. Just eeeew!
Bad flashbacks to the worms in Star Trek 2.
Alligator forceps are the necessity here. Don't know if they're indicated, contraindicated, or the complete wrong thing to do but I've pulled no less than 20 foreign bodies out of auditory canals with 'em over the years.
strange thing is I know of a patient who was screaming her head off over a gnat in her ear. The Saline worked once they kicked the parent out of the room ;)
OMG. I may never sleep again.
You are supposed to kill the roach first with some warm oil, (to avoid any nystagmus), and then try to fish it out.
Warm viscous lidocaine + Alligator clamps is our secret. We see about 10 or so of these cases a month. Last saw a bee in the ear. Blergh.
Did the *roach* break her membrane? Ooooog. Star Trek 2, yeah, ugh.
Oh this is gross. Bodily fluids? Sure. Blood? Yum. Ginormous abscess exploding and spraying stinking pus all over? Okay.
But insects breaching the skin and going where they shouldn't, that is beyond gross. EWWWW!
An easy way to kill any insects is using silicon dioxide.
It is quartz kristal in powdered form, used as an agent to prevent clumping in salt, flour, stabilize sauces and also meds during mixing and grinding powders.
Most tablets are made with it..it is like KJ for processing.
But it also will destroy the oily film on insects so they will die in the matter of seconds because of dehydration.
It is non toxic for other animals or humans
This is my fucking WORST NIGHTMARE. Seriously I almost fell out of my chair!!!!!
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