Drainage of an auricular haematoma is one of the "new" practical procedures that has popped up on our e-portfolio. This is difficult to get signed off because there are minimal resources on it, and it's not a skill I've ever seen performed in the ED. I'm not sure if it's because I'm missing them, and not looking hard enough for them, or if it quite simply isn't a procedure we do in the ED. I've seen ear lacs and swollen ears - I must be missing something.
What is An Auricular Haematoma?
An auricular haematoma is a collection of blood that forms between the cartilage and the perichondrium of the ear. It is most often caused by blunt trauma to the ear.
Initial Treatment
Needle aspiration is often recommended. This failed in 75% of cases - maybe because the needle itself introduces haematoma.
Incision and Drainage
Incise along an anatomic crease to avoid a scar. Use forceps to encourage all of the haematoma out. Put a drain in, and then a dressing for compression. Prophylactic antibiotics have no evidence.
https://www.ebmedicine.net/topics.php?paction=showTopic&topic_id=228
http://lifeinthefastlane.com/common-ear-complaints-in-the-ed/
http://journals.lww.com/em-news/Fulltext/2006/04000/Diagnosis__Traumatic_Auricular_Hematoma.20.aspx
http://www.epmonthly.com/departments/clinical-skills/visual-dx/how-to-treat-an-auricular-hematoma-in-the-emergency-department-photo-guide/
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