Earache/otitis referral checklist

Referral checklist for recurrent, severe, or complicated ear infections and persistent ear pain.

Last reviewed February 7, 2026

Urgency tier

Same-day escalation for mastoiditis concern, toxic appearance, or neurologic complications.
Expedited referral for recurrent infections with hearing or developmental concern.
Routine referral for persistent non-urgent symptoms despite first-line management.

Minimum pre-referral workup

Symptom chronology, fever burden, and pain severity assessment.
Otoscopic findings and recurrence history.
Initial treatment response and adherence review.

Referral packet checklist

Structured symptom course and exam findings.
Treatments tried, duration, and response timeline.
Relevant comorbidities, medications, and hearing-risk context.

Pre-referral optimization tasks

Reinforce analgesia plan and hydration monitoring.
Provide return precautions for worsening fever, swelling, or neurologic symptoms.
Arrange follow-up while awaiting specialist review.

References

Canadian Paediatric Society position statements (opens in a new tab)

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