Cuts and Wounds of the External Ear
Children may get minor cuts, wounds, and lacerations to the external (outer) part of the ear while playing, climbing, or participating in sports activities. Most of these injuries can be handled at home with simple first-aid treatment.
First aid for superficial cuts and wounds
Stay calm. It is important for you to stay in control. Not only will you be able to make better decisions, your child will also be less likely to panic if you remain calm and reassuring.
Calm your child and let him or her know you can help.
Apply pressure with a clean cloth or bandage for several minutes to stop bleeding.
Wash your hands thoroughly.
Wash the cut area well with soap and water, but do not scrub the wound. Remove any dirt particles from the area and let the water from the faucet run over it for several minutes. A dirty cut or scrape that is not thoroughly cleaned can cause scarring and infection.
Apply an antiseptic lotion or cream.
Cover the area with an adhesive bandage or gauze pad. Change the dressing often.
Check the area each day and keep it clean and dry.
Avoid blowing on the abrasion, as this can cause germs to grow.
Any wound to the cartilage of the ear that is more than just a superficial cut or laceration should be evaluated by a healthcare provider to decide whether further treatment is needed.
Bruises, blisters, or swollen areas caused by trauma may be treated by placing an ice or cold pack on the area every 1 to 2 hours for 10 to 15 minutes for the first 24 hours. Do not put ice directly against the skin.
A direct blow or blunt trauma to the ear that causes a large bruise or hematoma (collection of blood and fluid underneath the skin) should be evaluated by a healthcare provider to decide whether further treatment is needed. If there is a bruise (contusion) in the cartilage, a condition known as a "perichondral hematoma" can develop. If the hematoma is not treated with drainage, it can cause a "cauliflower ear" deformity.
Use a sunscreen (sun protection factor, or SPF, at least 15 or greater) on healed cuts and wounds to help prevent scarring.
When should I call my child's healthcare provider?
Specific treatment for cuts and wounds of the ear that need more than minor treatment at home will be discussed by your child's healthcare provider. In general, call your child's healthcare provider for cuts and wounds of the ear that are:
Bleeding heavily and do not stop after 5 to 10 minutes of direct pressure. If the bleeding is profuse, hold pressure for 5 to 10 minutes without stopping to look at the cut. If the cloth becomes soaked with blood, put a new cloth on top of the old one. Do not lift the original cloth.
Deep or longer than 1/2 inch.
Accompanied by hearing loss
Caused by a puncture wound, or dirty or rusty object.
Embedded with debris, such as dirt, stones, or gravel.
Ragged or have separated edges.
Caused by an animal or human bite.
Excessively painful or if you suspect a fracture, head, or bone injury.
Showing signs of infection, such as increased warmth, redness, swelling, or drainage, even if the cut or wound is small.
Also call your child's healthcare provider if:
Your child has not had a tetanus vaccination within the past 5 years, or if you are unsure when your child's last tetanus shot was given.
You are concerned about the wound or have any questions.
Preventing ear injuries
The following are a few guidelines to help prevent ear injuries in children:
Teach your child not to poke or place objects in the ear, such as cotton swabs or pencils.
Teach your child to wear protective ear guards or helmets for sports activities that could cause injury.
If your child is planning to have his or her ears pierced, be sure it is done by a professional. Take care of your child's ears afterwards according to the instructions given.
March 21, 2017
Evaluation and Management of Middle Ear Trauma. UpToDate
Fraser, Marianne, MSN, RN,Kacker, Ashutosh, MD