EAR CAMP AUDIOLOGY GUIDELINES

guideline

These guidelines are old but offer a history of the way audiology began and has developed on the ear camps
December 2001

Debra Graumann

Setting up

On arrival get gauze and meths for disinfecting otoscope tips etc. If there is no table in the audiology room try to get one the day before all the patients start arriving, or you are likely to end up with people coming along to be tested while you are still trying to unpack!

Audiometry

2 audiometers available, both of which can be battery-powered. Only one of them has a patient response button. On the last camp I ended up doing almost exclusively 3-point audiograms (500, 2k and 4k) in order to keep up. Background noise levels can be very high so PTAs need to be taken with a pinch of salt!
All PTAs are carbon-copied, one copy goes back with the patient and the other stays with you. If you do have the time to get them into numerical order as the camp progresses that will save Ellen a lot of work at the end!

Otoscope and tympanometer tips

Clean and re-use. More otoscope tips available from OPD if necessary.

Hearing aids

All second-hand aids in the audiology trunk were checked and cleaned in November 2001. If you are adding any more to the stock, it would be helpful if you could either do the same or label them “to be checked” and keep them separately so that someone can go through them at some stage.

Hearing aids were sold to patients (in 2001), these are the charges I applied:

Hearing aid + mould: Ru. 500 (£5). Normally fit monaurally, however if you feel strongly that somebody ought to have 2 aids then don’t charge for the extra one.
Hearing aid + mould if patient has also had an operation on the same camp: Ru. 200
Replacement leads (2-3) for BW aids or replacement moulds: Ru. 50.

Prices can be adjusted in cases of genuine financial difficulty. I don’t get involved in these discussions as I feel I don’t know enough of the culture to suss out who’s genuinely hard up and who’s just trying it on! If the interpreter you’re working with isn’t comfortable with taking this on, Ekdev is very used to doing it, I sent most of mine to him.

Patients need to be given a receipt. Either send them to Ek dev to pay and tell them to come back with the receipt to collect the aid, or ask him to give you a receipt book so you can do your own.

Earmoulds

There is equipment in the audiology trunk for doing cold cure moulds, if you need any help in getting started with these ask Ek dev or Suresh, Suresh in particular has done quite a few.If you are doing a mould for a BW aid, fit the circlip in before it sets.
Once the mould has set, trim off both ends with a scalpel. For solid moulds, cut out the material inside the circlip.
With the scalpel tip, cut a small nick at both ends (this makes it easier to start drilling). Drill a pilot hole with the 1mm straight burr (easier to start from the canal end). Then use the 3mm circular burr to drill a larger hole.
Use the tubing threader to get the tubing in, the thick-walled tubing holds better.
If the canal is wide enough you can vent and fitting a bit of standard tubing through the vent will keep it from collapsing. I’ve done this experimentally but never on a patient!

Batteries

AA and LR6 batteries are easily available in Nepal. CP44 can be obtained but less easily and they are very expensive. There is currently a large stock of out of date CP44 batteries in the trunk. These were fine in November 2001 but need to be got rid of, so if they’re still OK in March give out lots with each aid (6 packs of 6 or more if you want! – they need to go!).

Kids

There are some smiley face stickers for paediatric patients with one of the audiometers but this doesn’t seem to be a particularly rewarding reward as far as they are concerned! Sweets go down very well, consider having a few at hand!

Last but not least...

The general philosophy of the camps is that everyone mucks in where needed, so if you run out of audiology jobs and are still standing it’s worth checking whether there are any jobs to be done in theatre or outpatients.
Don’t touch any equipment or even metal parts of its case with wet hands if it’s connected to the mains. Hospital wiring can be dodgy!