The Propulse III irrigator has a pressure variable control of minimum-maximum, allowing the flow of water to be easily controlled by commencing irrigation on the minimum setting. For patient safety, Propulse has limited the maximum pressure available; this limit is stated in the user instructions. GUIDANCE FOR EAR IRRIGATION USING THE ELECTRONIC IRRIGATOR This procedure is only to be carried out by a trained doctor, nurse or audiologist. PRINCIPLES - Irrigating the ear is carried out to: - Facilitate the removal of cerumen and foreign bodies which are not hygroscopic, from the external auditory meatus. Hydroscopic matter (such as peas and lentils will absorb the water and expand making removal more difficult. Remove discharge, keratin or debris from the external auditory meatus. An individual assessment should be made of every patient to ensure that they are appropriate for ear irrigation to be carried out. REASONS for using this procedure In order to: - Correctly treat otitis externa where the meatus is obscured by debris Improve conduction of sound to the tympanic membrane when it is blocked by wax. Remove debris to allow examination of the external auditory meatus and the tympanic membrane. Irrigation should not be carried out when: - The patient has previously experienced complications following this procedure in the past. There is a history of a middle ear infection in the last six weeks. The patient has undergone ANY form of ear surgery (apart from grommets that have extruded at least 18 months previously and the patient has been discharged from the ENT dept). The patient has a perforation or there is a history of a mucous discharge in the last year. The patient has a cleft palate (repaired or not). In the presence of acute otitis externa; an oedematous ear canal combined with pain and tenderness of the pinna..