Excellent! That kid is really nice! In small children, I do lift the angle of the handle a little more, so it's not my fingers that rest on the child's cheek, but the heel of my hand (hypothenar). On a lying infant or toddler, this provides even more control. Right ear - Right hand, Left ear - Left hand… Thank you for this excellent, detailed video.
Thank you so much for this Dr. Sylvester! I was wondering why it was so difficult to visualize the whole tm on a pediatric patient. I just need to bend their head a bit.
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I realize many professionals have been taught this method, but, please forgive me, it's always seemed a sloppy way of handling the otoscope. A sure and safe method is to grip the head of the otoscope between the thumb and first two fingers, letting the middle finger extend past the speculum to rest securely against the patient's head as you approach the canal (the 3rd and 4th fingers wrap around the otoscope handle). This gives extremely precise and safe control of the speculum in all cases. A right-hander can keep the otoscope in the right hand, there's no need to switch hands between ears. And in the video, when the doctor switches to the right ear, it appears he is no longer letting his knuckles rest against the patient's cheek as he places the tip of the speculum at the opening of the canal. Again, please forgive me, but that just appears a bit unsafe.
Thank you for your comment. I believe that there are several ways to safely and effectively use an otoscope. I must admit, I could not replicate your grip based on your description - perhaps you can offer a link or a photo. I bet we can agree that any grip that allows fine motor control, a good view of the TM, and protects the patient from harm is a good grip! If the user is more comfortable remaining with the dominant hand for both ears, so be it. I must admit, given that all medical students must switch hands for the arguably more complex skill of opthalmoscopy, I find it odd to recommend using only the dominant hand for otoscopy. But once again, if we use control, effectiveness and safety as a guide, we can't go wrong! Good catch! It does indeed appear that I have let go of my bracing finger on the close-up shot. I will put that down to the distraction of video work - and will hereby officially recommend against examining your patient while attempting close-up video!
