hawai'i guidelines
is a newborn hearing screening required in the state of hawai'i
yes, it is mandated by law
how do you turn on and set up an otoscope for proper use
push down on the green, red, or white button and slide clockwise and replace speculum
what are OAEs
OAEs are very soft sounds created by tiny movements of outer hair cells in the cochlea, in response to sound, and these sounds travel back to the ear canal where they can be measured over time
what does a pure tone assessment check for
checks how well you can hear different pitches (tones) at various loudness levels to see if you have hearing loss and how mild or severe it is
what does a tympanometry assessment measure
measures eardrum health and mobility in response to changes in air pressure within the ear canal
per state guidelines (2024), what dbHL should you start screening at in a pure tone screening
20 dBHL
what do we need to do before inserting the otoscope into a patient's ear to ensure that the speculum will not hurt/damage the ear canal
BRACE
how do you know if you passed an OAE assessment
the equipment will calibrate your result on its own
what should you check for on a child before conducting the PTA assessment (before placing headphones)
notice earrings, glasses, hats, hair, ear malformations, drainage, hearing aids, gum, etc.
when we conduct a tympanometry assessment, what PASS criteria are we looking for
if the tympanogram peak is within the "pass box"
per state guidelines, what frequencies should you test during pure tone screening
1,000; 2,000; 4,000; 6000 Hz
along with otoscopic inspection, what other screenings should be conducted around the same time
pure tone screening and tympanometry
what frequencies are OAEs completed at
2000, 3000, 4000, and 5000Hz
what are the proper steps you should take to SET UP for a hearing screening
make sure you are in a good acoustic environment; plug in audiometer; check earphone connections; turn on audiometer; check that earphones are securely attached to headset; conduct a listening check
what data does a tympanogram measure/show
TPP (tymp peak pressure), Ytm (compliance), TW (tymp width), ECV (ear canal volume)
per state guidelines, when do we PASS a PTA screening
if all the frequencies were heard and documented
upon otoscopic inspection, what ear canal abnormalities should we look to identify
blood or effusion (drainage), inflammation, excessive cerumen or foreign object
what is the criteria to pass an OAE assessment
you must pass 3 of the 4 test frequencies to pass the screening
what is the correct headphone placement when conducting PTA assessment
right ear-red; left ear-blue; adjust headband to child's head, put earphone diaphragm directly in front of the EAC before tightening the headband
what can a flat tympanogram indicate about the eardrum/middle ear
fluid behind the eardrum (often from an ear infection); perforation in the eardrum; earwax blocking the ear canal; problem with the ear tube (like a blocked or clogged pressure equalization tube, or user error)
what is the referral criterion for PTA per state guidelines
refer if any one frequency missed in either ear
upon otoscopic inspection, what tympanic membrane abnormalities should we look to identify
abnormal color, bulging or retraction, fluid line or bubbles, perforation or scarring, mass
what are the steps to conducting an OAE assessment
a small probe is placed in the ear canal; the equipment calibrates itself and 4 tones are played into the ear; the cochlea responds to these sounds through OHC movement and tiny reactive sounds; microphone detects OAEs; equipment analyzes whether OAEs are present
explain the screening procedure for PTA after successfully placing the headphones on the child
start at 40 dB HL (to let child know what to listen for) at 1000 Hz; once child responds to first tone at 40 dB HL, screen all other frequencies at 20 dB HL (can also start at 20 dB HL if quiet room & older children); watch tempo and document responses
tympanometry assessment procedure
conduct otoscopy; insert probe creating an airtight seal; probe emits a tone that changes the air pressure in the canal; microphone records eardrum movement in response to pressure change; data is converted into a tympanogram