Welch Allyn REF 29400 - Manual (Page 19)

Welch Allyn OAE Hearing Screener Directions for Use 705353 Rev E
18
Obstructions
Problem Possible solutions
♦ Cerumen, vernix, or other debris
— In the ear
— On the probe tip
— On the probe
♦ IN THE EAR:
— Make sure that a properly trained technician examines
the ear canal for obstructions BEFORE inserting the
probe.
— Delay testing newborns until 11 hours after birth, if
possible.
(Note: 'Refer' results caused by vernix decrease
with each hour after birth.)
♦ ON THE PROBE TIP:
— Remove, discard, and replace the probe tip before
each test (optimal).
— Remove, examine, and wipe probe tip clean; make
sure that both the inside and outside of the tip are
clean; replace cleaned probe tip.
♦ ON THE PROBE:
— Clean the probe carefully by following the instuctions in
the Directions for Use guide.
♦ Temporary collapse of the ear canal
— Occurs often with "down ear" when infant
is lying on side.
— Collapse is normal because bones
haven't formed in ear yet.
♦ Manipulate the ear in a gentle, circular motion before
inserting the ear tip.
♦ Make sure to have a good probe fit.
♦ If infant is lying on side, reposition infant so that down ear
faces up; ask attending nurse or parent to keep infant in
this position as much as possible; wait a few hours before
testing "down" ear.
Cochlear Outer Hair Cell Loss
♦ Hearing loss
— Problems include communication difficulties in noisy environments and speech and language development
delays.
♦ Refer on OAE and not on Pure Tone Audiometry
— Occurs most frequently in people exposed to high levels of sound energy (noise or music) or those treated
with ototoxic medications.
— OAE responses are often affected before evidence of hearing threshold change appears on a behavioral
hearing test.
False Positives
♦ 'Refer' criteria maximizes the detection of individuals with true hearing impairment.
♦ A small percentage of people with normal hearing sometimes get a 'Refer' result.
— These are people whose OAE responses fall below the 10th percentile for the normal population.
— Such low OAE responses warrant additional testing.