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This was a topic of debate at work a while back, due to a patient we dealt with a few days prior who had a cockroach in her ear. After much fighting, kicking and screaming we finally got the med student calmed down....turns out she has a pathological fear of bugs....enough to get her to flood the patient's ear canal- or to use the technical term the patient used to describe the situation "ear hole"- with lidocaine to kill the bug which was then removed without incident. One of my coworkers said we should have used alcohol to kill the bug, another suggested plain old saline. Anyone else have an opinion or other suggestions on how to handle this common problem?