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Mrs Chanker is a 76 year old female who you saw five days ago with impacted wax. After detailed assessment you advised Sodium bicarbonate drops, with a view to attempting ear irrigation following this. She has returned today to see the new practice nurse, she reports good compliance with drops and is keen to proceed with irrigation as she is struggling to hear. Mrs Chanker has mild COPD and glaucoma but is otherwise fit and well. She is mostly independent at home but has some help with shopping and cleaning. With consent the nurse attempts irrigation, but is unable to clear the wax. She comes to you for advice.

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