Chapter 3: environment and patient preparation, Patient preparation – Welch Allyn REF 29400 User Manual

Page 11

Advertising
background image

Welch Allyn OAE Hearing Screener Directions for Use 705353 Rev E

10

Chapter 3: Environment and Patient Preparation

There is minimal patient preparation required for an OAE test. Since the test measures a
physiologic event, no behavioral response is required from the patient. Therefore, OAEs can be
recorded on sleeping individuals or on patients who cannot reliably perform a pure tone
audiometric test of hearing either because of illness, language barrier, developmental delays or
cognitive deficits.

It is necessary, however, that the patient cooperate by allowing for insertion of the ear tip into the
ear canal and by leaving the ear tip in place for the duration of the test. Depending on the test
parameters used, the patient’s emissions and the level of background noise, test time can vary
from as little as 10 seconds to several minutes.

During the OAE test, very soft sounds are measured by the probe in the patient’s ear canal.
Because sound measurements are being performed it is important that the noise in the
environment be controlled as much as possible. OAE tests are fastest when the background
noise and patient generated noise is low. Be aware of sources of noise in the room. Take
measures to control them or find a quieter room, if possible.

Patient Preparation

1. If you are trained and equipped to perform an examination of the ear canal with an otoscope,

it is highly recommended that you do so prior to insertion of the ear tip into the patient’s ear.
Verify that the ear canal is clear of cerumen (earwax) that can interfere with the OAE test.
Performing an OAE test on an ear draining fluid is not recommended.


2. Select a disposable ear tip that seems appropriate for the size of the patient’s ear canal and

install it on the probe. Use the largest ear tip that will fit into the patient’s ear canal. An ear tip
that is too small will result in low stimulus intensity and may cause a refer result. (See
Chapter 4 for proper ear tip instructions.)


3. Insert the ear tip into the patient’s ear canal. When using the larger size foam tips, be sure to

compress the tip with your fingers until it is a small diameter cylinder. Quickly, while it is still
compressed, gently pull up and back on the patient’s ear to straighten the ear canal and insert
the ear tip deeply and securely into the canal. Hold it in place for a few seconds while the
foam expands in the canal. If the ear tip stays in place without holding it, it is in securely.


4. When using the OAE Tree Ear Tip, gently pull down and back on the patient’s ear to

straighten the ear canal and insert the ear tip deeply and securely into the canal. If the ear tip
stays in place without holding it, it is in securely. Do not hold the probe in place as this will
create noise.


5. Clip the probe cord to the patient’s clothing, infant carry-all or bassinet with enough slack so

that it is not pulling down on the probe. This will reduce the chance that the weight of the
probe cord will pull the probe out of the ear. For young children, clipping the probe cable on
the back of the shirt could help prevent the child from grabbing the cable and pulling the probe
out of the ear.


6. When testing a newborn or young infant, it may be helpful to swaddle the baby in a blanket to

try to keep movement at a minimum. Placing the infant on his/her stomach or side with a
rolled blanket behind the back (to keep the baby from rolling onto his back) can facilitate
testing. With the test ear facing up, the probe is more likely to remain in the ear canal for the
duration of the test.

Advertising