The parent can steady the hands and feet from the other side of the table. A towel around the forehead can help comfort the child's head and make the head less slippery for the assistant to hold. The binocular permits a magnified view of the ear canal, which is under excellent illumination from the bright light. Prisms focus your binocular view directly down the ear canal, allowing for an excellent three dimensional view of the tympanic membrane after the cerumen has been removed. Here's a photo of the student using the ear curette to remove flakes of cerumen that are obstructing the view.
Older children sit in a comfortable swivel chair that can be positioned for the examiner's comfort.
The examiner sits on a low stool. She is pulling back on the pinna to straighten the ear canal. We rarely use the ear wash, because it takes a lot longer than removing wax carefully with a curette. But sometimes a wash is necessary if the wax is goopy.