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Protocol: Madsen AccuScreen
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1. Progress bar indicates test time relative to noise Test iy be short when noise is low but longer when it is high O W is more than 20 Incomplete 60 the test may also be t the screen again but only up If noise level becomes high Stability is less than 80 q the test may be stopped manually and the outcome w If the Probe fit assistant becomes grey it has falle stopped manually Improve the conditions and a to a maximum of 3 times Outcomes Clear response No clear ey Incomplete test CR and NCR result must not be ow Performing a test A least 1 metre awa ther electrical equipment Connect AABR or cables Connect ear cole cables attach ear phones The positions for each of the gel sensors and the colour codes of sensor cables are as follows Optimum test es are a Settled baby in a quiet environment and at Red Nape of neck Black back of the shoulder White high forehead At each sensor site gently hold the skin taut Wipe baby s skin 3 5 times with a dry prep pad Wipe baby s skin with either cotton wool or preferably gauze dampened with water to wipe away any dead skin loosened by the dry prep pad Apply gel sensor pads at each site gently holding the skin taut Sensor cables may be attached to the gel sensor pads either before or after placing on the baby Sensor cables should always be attached or removed when the device is switched on Never switch on or off with sensors attached to
2. the baby Place the ear phones over baby s ears making sure that they are sealed and that the speaker is no obscured by the pinna Red for the right ear and blue for the left ear Keep cables separate and not crossed Select ABR 45dB R and L Simultaneous Impedance levels will be displayed Good Impedance lt 6kQ Balance between red and white sensor lt 2kQ Press the start button arrow to proceed Fair Impedance between 6kQ and 12kQ A Balance between red and white sensor between 2kQ and 4 k N It is recommended that the test is stopped to re prep the po sensor Poor Q Impedance gt 12kQ U Balance between red and white sensor pads gt 4k It is not possible for the screen to proceed Stop the test re prep the skin and apply EN nsor apply a new Monitor the screening test O ABR bar Indicates the respo e EEG bar Indicates EEG trical and Muscle interference Progress bar Indicat ime relative to noise Test time will be short when interference is low w er when interference is higher Impedance level te every 20 seconds If conditions deteri ress pause Resume the scr in 3 minutes if conditions improve If conditions do n t Improve within 3 minutes stop the screen Stopping the test before completion whether automatically when paused for more than 3 minutes or manually will result in an incomplete test outcome NC Outcomes Clear response No clear response Incomplete test CR and NCR outcomes mus
3. Published 3 July 2015 NHS Screening Programmes Nevqborn Hearing S ay Protocol Madsen ARRESTO Table of contents TOrMiNOlOGY ccceceeeceeeeeeeeeenseeeeeeeseeeeeenseeeeeenzed Operating Instructions sseeeeeeee h E Quality Assurance tests oooooococccconncnnonconnoss Visual Inspection oooooncnnccnnccnnononnnonnnnos Data Upload SN Probe Test cnc N OA tests ammm N issue Sa EA ASEA E E E A E T A ETETA A A QA 1 Cavity Test AT ao QA 2 Occlusion A QA 3 Ear eesse QA 4Click Y A ese oes Screening Testeni iii dra Entering Demographic detailse eneinio ui aei aaia a A E i a deveeilascaedsecavaced aa abi anastaa Performing atest AQAE eserine p E E id Performing a test AA BR ii iia Uploading into e Ponciano de Downloading archive iia Ad a aia Maintenance and cleaning commmccccnnnnnccnnnnnccnncrn ennn n ennnen nnmnnn nnmnnn ennnen nnna Clean O NO Charging cari A A rc ay Manufacturer CallbralOMuiiii E E EVE E EE EE E S E TEk Ea Appendix lui n e E Galen E E A E E ieee aes 8 Part of Public Health England Notes It is expected that screeners will familiarise themselves with the contents of the manufacturer s manual as this protocol is not designed to replace it A detailed manual for Acculink may be accessed from the HELP icon in Acculink Terminology The AccuScreen consists of a small battery operated unit with detachable battery a charger and detachable probe electrode and speak
4. e Expor Data button on the hearing tab QA test data may also be exported as download button on the QA test results list Data may be exported individyallywnowever you will need data extracting software e g Win Zip for mult Aes Click on Result Viewer in neat o view the test results Click on Get Data Icon ane w the assistant to locate the data Maintenanc d cleaning Cleaning See Appendix 1 Manufacturer s Update to cleaning instructions The equipment should be cleaned before and after each baby and all procedures must be approved by local infection control Inspect the earpiece coupler regularly for contamination with debris or wax Change the coupler if visibly contaminated If the coupler becomes visibly contaminated during screening it can be cleaned with a cleaning wire and reused on the same baby only On completion of the screen replace the earpiece coupler with a new one If a coupler is changed during the course of the screening session a Probe test should be carried out to make sure that the new coupler hasn t affected the probe s output Battery Charging There is one battery which may be removed from the back of the unit by sliding the catch in the direction of the arrow The number of screening tests that a fully charged battery will allow will depend on the time that tests run Charging can take up to 4 hours Place Accuscreen in the docking station which is plugged into the mains supply The unit can be left t
5. e device the probe housing and cable is clean and undamaged Change the ear tip if required Data Upload Make sure that all data has been uploaded before starting a new screening session Notify the local manager of any instrument with data that cannot be uploaded That instrument must not be used until the problem has been resolved Probe Test This shows that the loud speaker provides enough sound to evoke a TEOAE and the microphone is sensitive enough to detect a TEOAE Insert the probe securely into the cavity on the back of the Accuscreen In Quality Tests Select Probe QA tests The QA tests are refreshed each time the Accuscreen is synchronized with Acculink and eSP This list will appear Press the List icon to view the list as SS QA1 A2 O QA3 al QA4 KU Press the list icon again to view the list as W QA Click QA Ear QA Occlusion A QA Cavity ES QA 1 Cavity Test gt g This test is for artefacts th ive rise to a false TEOAE Insert the probe into the cayvNy on the back of the Accuscreen In Find Patient Sel Cavity Select TEOAE e Test outcome de be NCR QA 2 Occlusion This demonstrates that the microphone does not pick up sound from the speaker and therefore that the ear piece and cover are assembled correctly In Find Patient Select QA Occlusion Place an ear tip onto the earpiece Occlude the end of the ear tip with a finger or thumb Select TEAOE R Inspect th
6. e waveform for artefacts that could be interpreted as a CR Test outcome should be NCR Stability 100 and Artefact 0 QA 3 Ear This is to check that the Accuscreen is able to record a TEOAE in a hearing ear In Find Patient Select QA Ear Using the yellow soft ear tip insert the ear piece into an adult ear Test outcome should be CR In cases where the tester does not normally get a CR then the usual expected result will suffice QA 4 Click This is a subjective test to check the AABR stimulus is being emitted via both loud speakers In Find Patient Select QA4 Click Clip the sensor clips onto the metal bars of the AABR tester Select ABR45 R and L simultaneous Impedance for forehead nape and balance should 0 Press arrow to start test and allow to run Listen to Right and then Left ear coupler for the clicking stimulus Stop the test x Screening Test 2 Vv Entering Demographic details K In New Patient Enter the following data Those marked are mandatory If the NHS r is unavailable the Hospital ID DOB and Family will be mandatory You_millIn t be able to carry out a screening test if the mandatory fields are empty ID O 10 digit NHS number Hospital ID Mandatory if NHRA Tiber is not available Family Name Mandatory if umber is not available DOB Date of Y NICU te Consent ull Screen only Risk factors nknown Consent should alw e Full as Screen only is no longer an option Any fi
7. eld can be e from the check screen by touching the field that you want to change Y Each risk factor status can be reset by touching the field to toggle from Unknown to No or again for Yes Performing a test TEOAE The optimum test conditions are a settled baby in a quite environment Place an ear tip on the earpiece coupler Choose a size that is large enough to provide a secure fit in the baby s ear Gently pull the pinna up and back to open the ear canal and insert the earpiece into the baby s ear Select TEOAE R or L During the initial calibration stage the stimulus will find its target level The green bar is a Probe Fit assistant which indicates whether the earpiece is sealed into the ear canal The bar will be grey less than 60 if there is a poor or leaky seal In this case consider reinserting the earpiece to achieve a better fit or refitting the earpiece with a larger ear tip The test will start automatically once the stimulus has reached its target level Monitor the screening test The probability that an AOAE is present is represented by a waveform Certainty that there is an AOAE is indicated by green dots on the waveform 8 green dots are required for a Clear response result Monitor the conditions throughout the screening test Probe fit indicates how well the ear piece is sealed into the ear Noise bar indicates the level of noise o Stability should be more than 80 Artefact should be less than 20
8. er cables In line with the family friendly approach the probe is referred to as an earpiece and electrodes will be referred to as sensors throughout this protocol The earpiece houses the loudspeaker microphone and a detachable coupler The coupler tip is covered by a coloured silicon eartip for insertion aie ear For AOAE this instrument uses TEOAE and will be referred to as such throbanh ut this protocol Operating Instructions gl Login KU After switching on a list of user names will apopeaNiNXe same format as it appears in eSP e g man_gallen Select your user name nter your password The password must be 8 characters long and co rat least 1upper and 1 lower case letter and a number Passwords must repeaters A generic user must not be used and should not appear in the on the Accuscreen Select the screening location fro e list of Inpatient Outpatient Home Visit Home Visit is not currently available Q Select the screening facilit eWacility in which the baby s record resides Quality Assurance Xx There are a series s and actions that must be carried out daily and it is best done in a quiet femme It is the screener s responsibility to report to the local manager and ren 6ve equipment that fails any of the QA tests from service until the problem has been resolved QA tests 1 2 3 84 are uploaded with screening tests to eSP to serve as a record that the equipment was functioning correctly on that day Visual Inspection Check that th
9. o charge overnight Manufacturer Calibration The Accuscreen has to be calibrated annually Appendix 1 g Otometrics Product Information Note Q Copyright GN Otometrics 2013 T 05 04 Rev A Date December 2013 xy Document No 7 40 07227 00 D Label Otometrics Product MADSEN AccuScreen PART number s 8 04 13900 8 04 13901 8 04 139 SEX 13908 8 04 13904 8 04 13905 8 04 13906 8 04 13907 8 04 1391 3020 Replaces N A Released by Jane Dal Topic AccuScreen Surface Cleaning 1 Description The cleaning instructions for uScreen surface have been updated Always make sure that n isture enters the probe the sockets data interface connector and probe plugs or th Cd vity Never immerse AccuScreen into water or other cleaning solutio e Use of cleaning agents other than those recommended in the user manual can cause damage to the device for example stress cracks in molded plastic For cleaning instructions in general please refer to the AccuScreen User Manual 2 Contact information For more information please contact product manager Jane Dala dalaa gnotometrics com We instruct using a moist ith alcohol to clean the surface of the device
10. t not be repeated If both ears Incomplete or one ear Incomplete and other CR or NCR the screen may be repeated on the ears with an Incomplete result when the conditions have improved When the baby is settled the environment is quiet and the electrical interference is minimal select start for the ear that corresponds to the ear to be tested and repeat the screen Uploading into eSP Each screener is responsible for the accuracy of screening data and uploading it into eSP at the end of the screening session Data must be uploaded within 24 hours of the screen being done Patient IDs screening outcome and test results are transferred to eSP deleted from the Accuscreen and Acculink Attach the docking station to the PC and the power supply Place the Accuscreen into the docking station Switch the Accuscreen on Select the Patients and Tests tab in Acculink Click on the Receive Icon Follow the Receiving Data Assistant to upload all the screening and QA data from the Accuscreen into Acculink The patient information fields will be populated SS Highlighting a Patient information field will reveal the test resu y Click on the Export Icon to export data to eSP If the upload is not successful data should arrive wie utes please refer to document Screening data not as P Downloading archive Y Test data including numerical data and the e ical waveform is stored in the baby s record in eSP Export data to your PC using th
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