Otitis externa – Paediatric

This RAC is applicable to referrals for patients aged <16 years only. Please refer to the Adult ENT RAC for referrals for patients aged 16 years or more.

Emergency and immediate referrals

Referral to Emergency Department

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergency medical advice if in a remote region:

  • Acute and or complicated mastoiditis
  • Acutely unwell diabetic patients
  • Any suspicions of the complications of Acute Suppurative Otitis Media i.e. Mastoiditis (proptosis of pinna), meningitis etc
  • Auricular haematoma
  • ENT conditions with associated neurological signs e.g. facial nerve palsy, profound vertigo and/or sudden deterioration in sensorineural hearing
  • Foreign body
  • New onset facial nerve palsy
  • Otitis externa with uncontrolled pain and/or cellulitis extending beyond the ear canal and/or ear canal is swollen shut
  • Patients experiencing facial weakness
  • Trauma

Immediately contact on-call registrar or service to arrange an immediate ENT assessment (seen within 7 days) for:

  • Facial cellulitis

To contact the relevant service, please see HealthPathways: Acute Paediatric ENT Assessment

Presenting issues
  • Chronic otitis externa (≥1 months duration) causing significant morbidity and not responding to recommended treatment
Mandatory referral information (referral will be returned if this information is not included)


  • Relevant history, onset, duration of symptoms including details of:
    • Otalgia, otorrhoea, hearing loss, pruritic ear canal, history of ear canal trauma e.g. cotton bud/hair pin
  • Details of previous treatment and outcome
  • Relevant past medical history including diabetic history
  • Degree of functional impairment e.g. quality of life


  • Ear swab M/C/S

If unable to attach reports, please include relevant information/findings in the body of the referral

Referrer to state reason if not able to include mandatory information in referral (e.g. patient unable to access test due to geographical location or financial cost)

Highly desirable referral information
  • Nil             
Indicative triage category
Indicative triage category
Category 1
Appointment within 30 days
  • Confirmed chronic otitis externa and persistent symptoms/pain and hearing loss despite maximal medical management
Category 2
Appointment within 90 days
  • Confirmed chronic otitis externa without pain
  • Associated dermatitis
Category 3
Appointment within 365 days
  • No category 3 criteria
Last reviewed: 26-05-2023

More information

Email: DOHSpecialistRAC@health.wa.gov.au