INPUT ARTICLE: Article: Put a new speculum, or pointed end, onto your otoscope before each patient. Select the largest possible speculum that your patient’s ear will accommodate. When inserted, the speculum should fit snugly into the outer third of the ear canal. Speculums that are too small can cause discomfort and reduce how much of the ear you can examine. Use the following guidelines for speculum size:  Adults: 4 to 6 millimeters Children: 3 to 4 millimeters Infants: as small as 2 millimeters Without using the otoscope, take a look at the person’s external ear and notice any redness, discharge or swelling. Manipulate the ear gently and ask the patient if there is any pain. With Swimmer’s ear there is often pain, swelling, redness, and discharge that can be observed before even using the otoscope. Place the otoscope at your patients ear, not in it. Look into your otoscope and then slowly insert the pointed end of it into the ear canal. Steady your hand on the side of the individuals face if necessary. Slow and gentle insertion can prevent unwanted movement in your patient. It also keeps your hand and scope in line with the ear and minimizes the risk of injury. Avoid putting too much pressure on the otoscope, which can bump the inner canal wall, causing the patient discomfort. Avoid ramming the speculum into the ear canal. Insert it at most 1 to 2 centimeters and then use the light to view beyond the tip of the speculum. Stop the examination immediately if the patient expresses any pain or discomfort. Examine the middle ear and eardrum. Angle the tip of the otoscope towards the person’s nose. This follows the normal angle of the ear canal. From here, move the otoscope gently at different angles. This allows you to view the person’s eardrum and canal walls. Stop the exam at any sign of increased pain or discomfort. Return the otoscope back to your starting position. As you watch through the speculum, gentle take the speculum and scope out of the person’s ear canal and outer ear. Release the person’s ear from your grasp. Remove the speculum from the otoscope. Throw it away in a certified medical waste container to minimize the spread of disease or infection to other patients. If you don’t have disposable speculums, scrub each tip with hot water to remove excess wax. Then soak the speculum in a covered dish of rubbing alcohol for 10 minutes.

SUMMARY: Choose the right speculum size. Examine the external ear first. Insert the otoscope slowly into the ear canal. Push the speculum 1 to 2 centimeters into the canal. Angle the otoscope. Remove the otoscope. Throw away the speculum.


INPUT ARTICLE: Article: Most homes built before 1970 often have lead-based paint on the walls, doorways, stairwells, and baseboards. If your home is old and you know it was built in the early or mid 1900s, it may have lead-based paint. Often, historic buildings or homes that are old and have not been renovated contain lead-based paint. If you do not own the home and are a renter, talk to your landlord about the age of the home. Ask them if they know if there is lead-based paint in the home. If you own the home, contact the previous owners to find out if they know if there is lead-based paint in the house. Examine the paint in the home to determine if it is peeling, flaking off, or deteriorating in any way. If it is lead-based, this may be cause for alarm. Lead-based paint that is deteriorating can pose a health hazard, as it will release lead dust as it breaks down.  Pay extra attention to paint that is on doorways or stairwells. These areas usually get more wear and tear, causing the paint to crack, flake, and peel. If you notice the paint is deteriorating and suspect it may be lead-based, test the paint so you can address the issue immediately.

SUMMARY: Determine if the paint is from 1970 or earlier. Talk to the owner of the home, or the previous owners. Check if the paint is deteriorating.


INPUT ARTICLE: Article: Cut an 18-inch (45 cm) piece of ribbon in a color or pattern your mom will love. Fold over one end to about an inch (2.5 cm), then fold it again. Sew or hot glue the fold closed. Fold the other end once to an inch, then place a hair elastic at the seam of the fold and fold the ribbon over again. Sew or glue the fold close. Glue or sew a button on the end without the elastic, on the front of the ribbon. This will be the opposite side of the ribbon from where you folded the ribbon down.  When you’re finished, place the elastic around the button to hold the bookmark closed. Customize the bookmark with your mom’s favorite colors, designs, or even characters! Clean an empty tin can well, using warm water mixed with the dish soap. Let the can completely air dry and then paint it in your mom’s favorite color. You can use ribbon or washi tape to decorate the can once it’s dry, adding a pretty design on top of the color you chose. To add a little something special, buy a small potted plant to put in the tin vase, or pick some flowers from your own garden. Just make sure you have permission to pick your own flowers! You can use any jar you like – a mason jar, an old vegetable jar – just make sure it’s cleaned out really well and smells fresh. Then write one memory of your mom on each slip of paper. When you’re finished, fold them in half and put them in the jar.  You should use at least twenty slips of paper so the jar looks pretty full. You can decorate the jar with stickers, craft paint, or ribbon. Make sure you write “Memory Jar” on the outside. Hole punch blank index cards in the upper left corner. On each card, write down one thing you love about your mom. When you’re finished, slip a binder ring through the hole in the all of the cards.  You can ask your whole family to participate, so she knows why you all love her. Try using different colored index cards or decorating them before you put the book together. It will make the book look more personal and let your mom know you spent a lot of time on it. This is a really great gift to make if you have siblings who want to help or be involved. And it's something your mom can keep for a long time, unlike real flowers!  Using a different color paint for each kid, dip your hands and feet in paint and then make a row of handprints or a row of footprints on a 36-inch (90 cm) wide piece of paper. When everyone is finished making their hand and footprints, let the papers completely dry. Cut out each foot or handprint. Arrange the cut-out hand and footprints in rows in a shallow half circle shape on a large piece of construction paper. When you’re happy with your design, glue them down. Roll the construction paper into a cone and glue or staple it closed.

SUMMARY:
Make ribbon bookmarks. Make a homemade tin can flower vase. Make a memory jar. Put together a “Things I love About You” Book. Make a handprint bouquet.