A mother brings her 4-year-old daughter in for a well-child visit. A 4th-year medical student was assigned to do the history and physical. The mother has no concerns, but the child is clearly not happy to be at the clinic. The medical student presents the following image to you from the Wispr digital otoscope and is concerned that the left ear “looks infected.” What learning opportunity does this present for the student?
The child has prominent vasculature (erythema, redness), likely from crying.
This is a great learning opportunity for the student. The Wispr otoscope allows the learner to complete the exam independently and then review the findings with the attending on the built-in screen. In this case, there is increased redness due to dilated vasculature. This is often seen in the case of a crying or breath-holding child. If too brief and transitory a view of the eardrum is obtained, it’s easy to associate the “redness” with an infection that is not present.