with CARL

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Recommended Equipment & Set Up

  • Your CARL (Basic or Pro)
  • Realistic or CARL Pro ears recommended for Otoscopy
  • Different CARL anatomies (for various specula sizes)
  • Various Otoscopy Models
  • Video Otoscope
  • Different Size Specula
  • ENT surgical microscopy
  • Head scope

To set up your CARL for Otoscopy, find a proper location to set CARL up. Ideally, this location will bring CARL to the appropriate eye-level height so the clinician can look in CARL's ear as they would a patient.

Both CARL mounts are available which offer variable height mounting for proper clinical technique.

CARL Competency Checks

The following competency checks can be used as checkpoints / tasks for standardized training of Otoscopy on CARL:

  1. Proper explanation of the procedure
  2. Proper holding of the otoscope
  3. Proper holding of the otoscope for left and right ear
  4. Comfort with various otoscope models available to them in clinic
  5. Comfort with operation of video otoscope and presentation of results to patient
  6. Proper selection of specula size
  7. Effective and safe pulling of the pinna
  8. Bracing technique
  9. Identify landmarks (eardrum, first bend, second bend)
  10. Identify cerumen
  11. Identify referral conditions

Technique Walkthrough

Step 1:
Choose the proper speculum size. Select the largest speculum that will fit comfortably in your client’s ear. 

Step 2: Hold the otoscope with the same hand as the ear you are assessing. For an adult, with your free hand, gently pull the pinna up and back to straighten the canal

Step 3: Using the same hand that is holding the otoscope, brace one or two fingers against the jawline in case of sudden movements.

Step 4: Gently move the otoscope into the proper position to view the ear canal and tympanic membrane. See Figure 1, for an example of how this looks with CARL including an inside view of his ear canal using a video otoscope. 

Step 5: Repeat procedure with next side and document the procedure as outlined by your licensing body. 

Figure 1

Technique Walkthrough Video

Otoscopy With CARL

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Technique Walkthrough Printable PDF

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Experience from the CARL Community

CARL has been an integral part of clinical training at the University of South Florida.  USF AuD students use CARL in their every semester as they learn to hold the otoscope and as they continue learning  how to take earmold impressions, perform probe mic measures, measure earmold tubing on a patient’s ears, and learn cerumen management techniques.  Having CARL is a way for students to comfortably practice skills and allows during learning labs for instructors and students to not always have to serve as the “test” ears. 

Devon Weist
University of South Florida

CARL has been an asset to student learning, especially during the pandemic when most instruction was remote. Students were able to come to the clinic and practice skills on CARL when they had limited access to patients. We have used CARL to practice otoscopy, REMs, earmold impressions, and transducer placement. I use CARL as the standardized patient for all practical exams and the Camera CARL allows me to observe students placing probe tubes to the proper depth during the assessment. We recently purchased a second CARL unit and I’m looking forward to trying more of the lesson plans available from the CARL Community.

Katherine Peitsch
Towson University

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