What should be your first step when a live insect is trapped in a child's ear canal?

When a live insect is trapped in a child's ear canal, the appropriate first step is to immobilize the insect with 2% lidocaine. This method is effective because it numbs the insect and prevents it from moving further into the ear canal, which can cause additional discomfort or injury to the child. Immobilization helps facilitate a safer and more controlled removal, reducing the likelihood of the insect reacting and potentially causing harm when attempting to extract it.

Using lidocaine also creates a more manageable situation for both the caregiver and the child, as it minimizes the child's anxiety and discomfort during the procedure. Once the insect is immobilized, it can be safely extracted using appropriate medical instruments, ensuring that the ear canal is protected throughout the process.

Other options may lead to complications or may not effectively address the situation. For instance, shining a light in the ear may not entice the insect to leave and could potentially irritate it further. Attempting to remove the insect directly with tweezers, without prior immobilization, could risk pushing the insect deeper into the canal or causing injury. Sedating the child with diazepam is not advisable as a first step because it’s unnecessary for a situation that can often be managed with simpler, less invasive methods.