What is the next step if a flashlight fails to coax an insect out of a child's ear?

When a flashlight fails to coax an insect out of a child's ear, the appropriate next step is to instill diluted alcohol into the ear. This action serves to help immobilize the insect, making it easier for it to be extracted. The alcohol can also help flush the insect out by causing it some distress, prompting it to move toward the outer ear where it can be more easily removed.

Using an otoscope may seem like a logical step, but it's essential that this only be done by a trained healthcare professional to avoid causing any further harm. Placing cotton in the ear would not address the underlying issue and could potentially push the insect further in. Administering antibiotics is not necessary at this stage, as the presence of the insect does not indicate an infection that requires immediate antibiotic treatment. Instilling diluted alcohol is therefore a safe and effective measure to take in this situation.