2) Heh, it's actually a standard board exam question about "homeless guy comes in with scratching in one ear." The official answer is that you /don't/ scope first, because if it's a roach, the sudden light can make them scrabble deeper. Which is actually funny, since different bugs respond differently - there have been case reports where people have reported repeated success with taking the patient to a darkened room, opening the ear as much as possible, and having a light pointed near the outside of the ear - luring the bug to crawl out on its own.
Actually, on second thought, I don't know if it's a "standard" board question. Rather, it was something I studied for boards once upon a time. I'm not in EM/FM, so it's not something I've ever had come up again.
would certainly try this before anything else. I use 1/4 3% peroxide, 1/4 70% isopropyl, and 1/2 water - if its too strong it will be uncomfortable.
I once woke up at 3:30 in the AM to the sensation of something crawling on my face. I sat up quickly and attempted to brush it off, but missed and the thing dashed into my ear. It went all the way in and nestled up to my ear drum. After getting over the initial uncertainty of not knowing whether it was that kind that bites, I thought I'd hang tight until the urgent care facility opened at 8:30 and have them take it out. But it moved around frequently, which made a significant sound as it rubbed against the tympanum, so there was no way I was going to sleep.
Yes, it is as unpleasant as you imagine it would be.
I couldn't stand the various maladies I dreamed up that might befall my hearing and after about an hour, I drove myself to the emergency room.
Here's where it's relevant to the story. At first, they couldn't see it with their otoscope, so they cleaned my ear out. In order to open space for a better look, they scooped out a disturbingly large amount of ear wax. I was surprised at this, as I do use Q-Tip daily and couldn't imagine that I'd missed that much wax when cleaning (I hadn't, Q-Tip doesn't reach there). And I'd recently had a full audiologist exam that found no issues. I asked the Dr. about it as he was locating the bug and he said that actually, the earwax in the ear canal is part of the body's protections against germs & viruses, and the amount removed was typical. Once the wax was out, he could see the thing.
They then 'paralyzed' it by squirting in an anesthetic so it wouldn't cling to my ear canal, then washed the ear out, and the bug came out.
$1,850 lighter, I headed home.
So. Learning that I could have had an eargasm and saved that small fortune, well, it's good to know for next time I'm in Vietnam with a bug in my ear.
For those who absolutely have to know... it was a silverfish. Ick.