There’s a hole in my Tympanic Membrane

What would be your next step in the management of this patient?

Whilst the child is waiting for you to discharge them, the mother calls you back into the cubicle as there has been some bloody discharge from the ear.

This is what you now see on otoscopy.

Image 2. via Wikipedia

What diagnosis is the image consistent with?

During your discussion with the ear, nose & throat (ENT) registrar, they ask if you have any suspicion of an inflicted (non-accidental) injury, as these can sometimes be precipitated by blows to the head.

You are satisfied that the parent and child have been under observation in the department, and that this particular child had a history and examination consistent with acute otitis media.

However, if there had been safeguarding concerns, what would have been the best next step in management?