Monday, April 30, 2012

Ear Infections, Broken Bones,

$7 128 Hz Tuning fork and $13 Stethoscope
With the tines vibrating, place the base on the bone 3-4 inches away from the pain center on a non-painful area. The vibrations will cause the ends of the bone to shift on each other which will cause pain. If the pain increases sharply, it is very likely there is a broken bone. If the pain does not increase, it is possible there is not a broken bone. For the long bones you can increase the sensitivity of the test by placing the stethoscope proximal to the suspected fracture and the tuning fork distal to the fracture. Decreased sound reaching the stethoscope (compared to the normal side) indicates the bone is broken. Sensitivity and specificity are both about 80% which means that if you test ten bones you suspect are broken, you will be wrong twice (whether you say it is broken and really isn't, or not broken when it really is.)

$30 Otoscope
Place the tip near the ear canal. You will find you need to lightly pull up and back on the ear to make a clean entry into the ear canal. The child will feel some pressure and may squirm so be careful not to puncture anything. You should be able to see the ear drum reflecting some of the light. If there is an ear infection the skin will appear red, the ear drum may appear to bulge out towards you causing some scattering of the reflected light.

I have no idea how good the $13 stethoscope you can get on actually is. For comparison, mine cost $150. My tuning fork cost about $7. My oto/ophthalmoscope set was almost $500, but you can easily diagnose an ear infection if you can visualize the area which you should be able to do with the inexpensive otoscope on

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