Patient selection: acute otitis externa
Parameters:
(1) age in years
(2) recurrent acute otitis externa
(3) current chemotherapy or radiotherapy
(4) diabetes mellitus
(5) immunocompromised
(6) unplanned re-presentation of acute otitis externa symptoms in the first 10 days of treatment
(7) acute otitis externa unresolved after more than 14 days despite treatment
(8) cranial nerve palsy
(9) disproportionate ipsilateral head pain
(10) erythema and swelling of the pinna or face
(11) completely stenosed ear canal
1 point is assigned if one or more of the following is present:
(1) age > 65 years
(2) recurrent acute otitis media
(3) current radiotherapy or radiotherapy
(4) diabetes mellitus, well-controlled
2 points are assigned if one or both of the following is present:
(1) immunocompromised
(2) diabetes mellitus, poorly-controlled
3 points are assigned if one or more of the following is present:
(1) unplanned re-presentation
(2) acute otitis externa unresolved
5 points are assigned if one or more of the following red flags are present:
(1) cranial palsy
(2) disproportionate ipsilateral ear pain
(3) erythema and swelling
(4) completely stenosed ear canal
total score =
= SUM(points for all of the scored items)
Interpretation:
• minimum score: 0
• maximum score: 11
• The higher the score the greater the risk.
|
Total Score
|
Action
|
|
0
|
discharge with prescription and safety net
|
|
1 or 2
|
active monitoring
|
|
3 or 4
|
specialist referral within 12-48 hours
|
|
>= 5
|
immediate specialist referral
|
