User`s Manual, Tympanometer, Earscan ES-TRAM
Contents
1. 1 Using a suitable wrench not pliers unscrew the white probe tip from the probe housing 2 Being careful not to bend or disturb the hypodermic tube which the tip fits over pull the tip free from the probe housing 3 Use a pipe cleaner or similar object to push debris from inside the probe tip The tip may be washed in a mild soap solution 4 Before replacing the probe tip remove any material from the threads such as Teflon tape 5 Lubricate the threads with a small amount of petroleum jelly 6 Being careful not to push any lubricant or debris into the hypodermic tube place the tip over the hypodermic tube and engage the threads 7 Thread the tip back into the probe housing and gently tighten using a wrench Be careful not to deform the plastic Wipe off any excess thread lubricant 8 Verify that the threads were sealed properly by performing a calibration test PUB 114 Rev B doc 19 User s Manual Tympanometer ES TRAM 4 2 Elementary Troubleshooting The only user level troubleshooting available on the Earscan tympanometer are the basic things such as verify that all plugs are fully inserted into their connection jacks ensure that power is available to the unit and the power cord is plugged in at both ends check to see that the power switch is on visually examine the probe cable to ensure it is not pinched kinked or otherwise damaged ensure that the probe tip is fully screwed into the probe housing check the2. 3 procedure 13 15 troubleshooting 20 probe See tympanometry probe probe cable avoid kinking 2 10 17 cleaning 19 dual function air and electrical 2 dual function image 3 inspection 20 susceptibility to noise 2 10 13 17 probe housing image 19 general reference 2 19 20 probe tip 19 image 19 cleaning 19 general reference 2 20 installing calibration cavity 13 installing ear cuff 14 removal 19 Tympanometer ES TRAM procedure 10 procedure fast 15 procedure normal 14 process of generation 1 saving to case 15 tympanometer function 1 power switch See power switch tympanometer principal components 2 sequence of operation 1 Tympanometer button 7 tympanometer module See Earscan module Tympanometer screen calibration data display image 9 calibration instructions image 8 data display image 11 fast tympanometry instructions image 10 first screen image 7 image label text box image 11 Left button image 11 normal tympanometry instructions image 9 Right button image 11 tympanometry probe automatic sensing 6 BLOCK message 5 calibration procedure 5 8 13 components of 2 correct alignment 5 17 correct handling 17 general reference 6 9 noise from rough handling 10 precaution 2 REMOVE PROBE message 5 6 13 14 Right button 11 Save button function 8 on Tympanometer screen image 7 procedure 15 sequence of operation 1
3. adjusts to fit data Acoustic Reflex Test Ipsilateral Tone presented af 1000 Hr and 105 dE Red box shows normal range for peak compliance Click button to label left or right ear WN RIGHT 17 00 27 Ear Len Figure 14 Data from normal tympanogram displayed on Tympanometer screen PUB 114 Rev B doc 11 User s Manual Tympanometer ES TRAM Figure 15 shows a graph that illustrates how the numerical data correlates with the graphic representation The volume of the ear canal is not shown graphically 1 0 Pressure in middle ear shows up as positive or negative offset from 0 daPa Maximum compliance of the ear drum shows its flexibility Compliance milliliters O an 0 300 200 100 0 100 200 Pressure Width of graph dekapascals at 50 of maximum compliance is the gradient which indicates the relative flatness of the response curve Figure 15 Elements of the tympanogram 1 2 Particulars of the AFHCAN Installation The Earscan tympanometer has been reprogrammed to work efficiently on an AFHCAN Cart All but four of the buttons on the front panel of the Earscan module are covered Most of the features associated with those buttons pertain to custom setups that are operationally complex and beyond the needs that the AFHCAN Cart is designed to address The SPEC button has been redefined When pressed the SPEC button places the tympanometer in fast tympanometer mode PUB 114 Rev B doc 12 Se
4. called the acoustic reflex Results of these tests are displayed both graphically and numerically The test takes place in two parts the first part generates the tympanogram and the second part generates two loud tones that test the acoustic reflex When a normal tympanogram is selected the two tests only takes about 12 seconds For children who have trouble sitting still a fast tympanogram can be selected which takes about 7 seconds With the fast tympanogram fewer measurements are taken so there is a slight loss of resolution in the data With either type of test if the instrument is removed before the acoustic reflex test is complete the tympanogram data will still be displayed but no results will be graphed for the acoustic reflex tests The tympanometer works as follows a probe with a rubber tip ear cuff fits into the ear canal making an air tight seal The probe generates a very small amount of positive air pressure in the ear canal and reduces that to a small negative pressure Normally when the pressure applied to the eardrum is higher or lower than ambient atmospheric pressure the eardrum will be pushed inward or pulled outward As the eardrum nears its limit of travel it tends to be tighter As the tympanometer sweeps through the pressure range it also generates a sound A microphone senses how much of this sound is reflected off the eardrum The amount of sound reflected off the eardrum at any moment indicates how tight it is
5. if necessary and check the patient s ear for excessive wax or the presence of a foreign object Reposition the probe and try again c when the LCD display says STEADY hold the probe steady d when the LCD display says gt TESTING lt continue to hold the probe steady e when the LCD display says REMOVE PROBE the test is complete and the probe can be removed Note Normal tympanometry takes about 12 seconds to complete the tympanogram and the acoustic reflex tests If you remove the ear probe after 7 seconds of testing just before the tones take place the tympanometer may download the tympanogram data without the data from the acoustic reflex tests If a tympanogram was successfully downloaded it will be good medical information and may be sufficient for your purposes f when the LCD display says BUSY it is downloading the data to the computer g on completion of the download the response curve of the tympanogram will be displayed on the LCD display The data from the tympanogram will automatically be displayed on the Tympanometer screen a press the Right or Left button as appropriate to label which ear was tested b if there is a question about the quality of the data retest the ear PUB 114 Rev B doc 14 User s Manual Tympanometer ES TRAM 7 For the sake of comparison it is always a good practice to test the other ear 8 On the 7ympanometer screen a click all thumbnails to review the data b click on t
6. E 1 L Mam Components ei cic ein Sas ce elas Sede a daa een acta poi a ad net 2 t i3 Hardware Controls and Indicators suine a a 4 kls Tympanometer SChCCM ees a E E EE 7 1 2 Particulars of the AFHCAN Installation ec cecesccesccsccesccnscessesscessescessescescs 12 SOCHON 2 OPOk ANON rss densa aa a denn sn due esse SERENE NENS ERE aeg 13 21 ASIC OD Taune Proce OUT ES S RSSER SER PERS a A SEEREN DELSE A 13 Zhi Stake the Tympanome Es osse T he Fo En oase 13 PA BE Caran EEEE REE EOS RE ENE T REESE NE ARENSE SE NN E REESE eee EET GENER SEE SENER EET 13 22 Normat FIM DAN OC CAA Matas sis cae E an ane ska de 14 2 Aas Cy 1 5 2 ST OT a T ETE ERNE ERNE TERE ES ERE SE EEN E ER SEERE E EO EIEE S TET 15 Section 3 Clinical Considerations ccccccccccccssccccccccccccccccccccccccccccccccccscccscccscccscccsoscccsceeccees 17 3 1 Guidelines for Clinical SUCCESS x ssa eases EA es RE ease ea dads RG Rata ee 17 JS COMMON MI Stak eS 2 sanserne nere aa te dene sa bed a de eter baw DRE Sea 17 23 TOPS AIC LACKS BEDER RE 5 il FRR RE SERISBEREE a ENE ERE nanan steno cadet a Na 17 Section 4 Routine Maintenance ccccccccccccccccccccsccscccccccscccscccscccccccsccccccccccccccccccsccccccccccsccccees 19 Bs Crean C16 AMIN es TERESE SEERE ata a gene aroun een ne ahaa Ne nine ua TESTES Eee TET BESES ENS SE ie tages nea 19 AD Blementary Troubles hOOuUn eson 20 PUB 114 Rev B doc jii User s Manual Tympanometer ES TRAM Figure
7. Each change in pressure results in a different degree of tightness The graph of pressure and tightness at a sequence of pressures results in a tympanogram Monitoring the amount of air necessary to sweep through a range of air pressures allows the volume of the ear canal to be estimated In the acoustic reflex test two loud tones are presented to the ear If a sound is loud enough muscles in the middle ear pull the stapes out of the oval window on the cochlea thus protecting the inner ear This response can be measured by the Earscan tympanometer The Earscan acoustic reflex test is a very limited screening level test A full battery of acoustic reflex testing is outside the capabilities of the Earscan tympanometer User interaction with the tympanometer takes place primarily through the controls and display on the Earscan module PUB 114 Rev B doc 1 User s Manual Tympanometer ES TRAM 1 1 2 Main Components The Earscan tympanometer consists of the following components Figures through 5 e electronics module power cord serial data cable e tympanometry probe Buttons within red box are covered when Earscan Figure 1 Watch for messages User controls Earscan probe housing probe tip ear cuffs in various sizes calibration cavity 1 4 inch stereo phone plug connector and tube for pressurized air Note The cable for the tympanometry probe contains both electrical wiring and a tube for delivering air When usin
8. SPEC button altered function 5 12 function 7 on front panel image 2 on screen instructions image 10 procedure 5 13 15 result when pushed 10 STEADY message 6 14 TESTING message 6 14 tympanogram desired characteristics 17 duration of test 14 general reference 1 interpretation image 12 LCD display and on screen image 4 multiple tests 11 on screen results image 11 premature removal 14 procedure 6 14 PUB 114 Rev B doc 22
9. Se COO WON Aa BW NO om he OV nA BB W WN Table List of Illustrations Title Page AES Cali module ROR rosa asier elske a cau cost sareaiacestecnetet 2 arse anmode Dac kK acer swan a a E A tadacaeenet ial denser 3 Earscan module connectors on right side cceceeccccccceesseeeeeeeceeeecaeeeseeeceeeeeeesaaeeseeeeeeeeeas 3 Earscan module connectors and power switch ON tOP ccceccccesssssseseeeeeeeeaeeeeeeeceeeeeeaas 3 ad CUlis aia Cal iOrAlOn CAVA oaa lien cost itaseaiaiaatanes aaa eatlensenetidtaseaniancimeeiaeal SEERE DEDE SEERE 4 Comparison of tympanogram on LCD display and on screen report ec ee cece eeees 4 Mita SCreen TOP Cy Mpa ONIe 1y sis sorte E ae et er ale 7 Instructional screen for the CAL button cc scsesacsataotcdcdesssagasnacatis sastiaasatndedeuassanpedaccodasaelinge tac 8 Instructional screen for the IMP Dutton scssi Sond picked bananen ose Sodio 9 Tympanometer screen showing Calibration data ccccccccccccsssseseseeceeecceeaeeeeseeceeeeeeaeeeeees 9 Example of noise introduced during Calibration cccccccsseeesecceeccceeeeeseecceseeeaaaeeseeeeees 10 Instructional screen tor the SPEC button 4 4ine eee reen eee e eee renee eee eee e eee reeeeeeee 10 PA UCHIOIMELEY error MESS ASE aa at he RE ne ial ne eee keen NES cians kig 11 Data from normal tympanogram displayed on Tympanometer screen 11 EBlements OF me tympan tania ere NR hjernen gas hen bek Deres des serne 12 Removing INO
10. as for a normal tympanogram Figure 12 Instructional screen for the SPEC button PUB 114 Rev B doc 10 User s Manual Tympanometer ES TRAM If the AUD button on the Earscan module is pushed while the Tympanometry screen is displayed the message shown in Figure 13 will appear To stop the audiometry test press the AUD button again and press OK on the screen to clear the error messages Audiometry can t be performed from this screen lf the AUD key was pressed accidentally please press the appropriate tympanometry key again If you would like to perform audiometry please go Back and select Audiometer from the Add to Case screen Figure 13 Audiometry error message Once the Earscan module has entered normal tympanometry mode one or more normal tympanograms can be taken in sequence It is not necessary to press the IMP button again unless you want to change to one of the other modes calibration or fast tympanogram As soon as the test is complete a screen similar to Figure 14 will come up prigi MULA Api Pees Te Han toe 2 Peir Agee eed Patient Goodhealth Max 34 yrs M Moose Pass Clinic H 33 Sherw ood hame Log Out Date 11757505 Tima 170037 Label RIGHT 17 00 77 Tympanogram Normal Speed Hange of Humek Young Child Adult Fremme fal middle aad 13 daPa 100 100 10 100 l Gradient porre with bb dara 60 10 40 710 O27 15 D 15 Numerical data Vertical scale of tympanogram automatically
11. on front panel image 2 result when pushed 5 8 on screen instructions image 9 CALIBRATING message 5 procedure 5 7 11 13 14 calibration result when pushed 6 data dislay image 9 INSERT PROBE IN CAL CAVITY message 5 example of noise in cable 10 LCD display general reference 6 8 9 17 data display image 4 initiating 7 function 4 operational check 19 general reference 6 8 13 procedure 5 13 list of messages displayed 5 removing calibration data from case 13 monitored by operator 13 results displayed 8 monitored by user 1 test parameters 13 on front panel image 2 testing frequency 5 13 responses to specific messages 14 thumbnail of calibration data 9 specific messages See message text calibration cavity Left button 11 correctly installed image 4 messages displayed on LCD general reference 2 details See text of specific message procedure 5 8 9 13 list of 5 calibration tool See calibration cavity MICRO AUDIOMETRIX EX71A message 5 Case screen 8 modes of operation ear cuff calibration 5 11 AIR LEAK error message 5 fast tympanogram 7 11 12 13 15 PUB 114 Rev B doc 21 User s Manual impedence mode See normal tympanogram normal tympanogram 1 6 7 11 NO DATA message 6 NORMAL TYPM message 6 NOT CONNECTED message 6 power distribution strategy 4 power switch cart main 4 power switch tympanometer function 4 general reference 6 normally ON 4 on top of unit image
12. probe 11D pass he pas a ie aaa taal ed eds sea nase adda eno 19 List of Tables Title Page EP arsean 2 emer ale d Iie SS AS es opna a E capa tencadwedestcananse 5 Active buttons on Earscan electronics module and their functions cccceeeeeeeseeeeeeeeees 6 Buttons on Tympanometer screen their functions seseessssssssssssseeeterrressssssssssssssssssseen 8 PUB 114 Rev B doc iV User s Manual Tympanometer ES TRAM Preface About this Document This document is part of the set of user manuals provided with the AFHCAN Cart These user manuals covering various topics are normally assembled into a binder delivered with each Cart This modular design has the following advantages e the set of manuals provided with your cart includes documents for the specific peripheral devices installed e each document is a stand alone publication so as new devices or features are added to the Cart new manuals can be added to the existing binder e user information that is common to all items of equipment does not need to be repeated in each module but can be covered in separate modules and referenced as needed One Device Two Functions and Two Sections The Earscan ES TRAM includes audiometry and tympanometry functions in the same unit Because these functions are handled by separate areas in the AFHCAN software the two functions are covered in their own sections of this binder Refer to the Audiometry Section for information on
13. User s Manual Tympanometer Earscan ES TRAM Document ID PUB 114 Revision B User s Manual Tympanometer ES TRAM The names of any providers and patients used in illustrations or examples in this document are fictitious Every effort has been made to ensure this manual is accurate complete and useful Please contact us if you have any suggestions for improvement AFHCAN Training Department 4000 Ambassador Drive Anchorage AK 99508 Phone 877 885 5672 Fax 907 729 2269 Email customersupport afhcan org Copyright 2006 Alaska Native Tribal Health Consortium ANTHC All rights reserved No part of this publication may be reproduced stored in a retrieval system or transmitted in any form or by any means including photocopying electronic mechanical recording or otherwise without the prior written permission of Alaska Native Tribal Health Consortium PUB 114 Rev B doc ji User s Manual Tympanometer ES TRAM Table of Contents Section Title Page POU ACC ease RES ES ERE eae E aea e SETE EE TE SEES ER ES V AVUN DOC UTNE IE ersa A O aa V One Device Two Functions and Two Sections cece ceecsecsscesccscceceecceccscesccesesscsseuscsceccesces V Rere COG Ie ES e a A E EEN V For More Int Ori aio iiaee A a V Secho 1 Tod chon sne a aaa a a ea edas 1 1 1 Becoming Familiar With the Tympanometer ccccseessscceccecceceeeeseeeececeeseeeeseseceeeenaaas 1 llt Functional Desci pi Oiicsscenan a a E E
14. all the calibration cavity This message displays briefly when the Earscan module is first powered up Micro Audiometrics is the manufacturer The third line in this case EX71A identifies the EPROM version which is similar to a software version User s Manual Tympanometer ES TRAM Message on LCD Display Meaning NO DATA Indicates that a normal or fast tympanomei ry test has been initiated and the Earscan device is ready to begin testing but the probe is not in proximity to an ear Proceed with test by inserting probe into ear NORMAL TYMP Indicates that the user has pushed the IMP button on the Earscan module to initiate a normal tympanometry test Insert the probe into the patient s ear and proceed with the test NOT CONNECTED Indicates the Earscan module is on power switch set to the ON position but the Tympanometer button has not been pushed see the Add To Case screen and the AFHCAN software is not yet displaying the Tympanometer screen To correct the situation simply continue through the AFHCAN software as necessary to display the Tympanometer screen However be aware that the NOT CONNECTED message will remain on the Earscan display until you push a button on the Earscan module to initiate calibration or testing Once a button is pushed on the Earscan module the Earscan display will update with an appropriate message REMOVE PROBE Indicates that the test has been successfully completed STEADY Thi
15. audiometry Related Documents This document assumes you have read the introductory hardware and software manuals included in this binder The original manuals provided with the equipment were included in a set of materials delivered with the AFHCAN Cart Those manuals can be used to supplemental the information provided in this document Be aware however that items installed on an AFHCAN Cart may have been modified slightly so the features as described in the original product manuals may not apply For More Information This document describes the equipment to a level of detail that will meet most user s needs in the context of clinical use of the AFHCAN Cart For more information contact AFHCAN Customer Support AFHCAN Customer Support Phone 888 449 4435 Fax 907 729 2269 email customersupport afhcan org Additional information can be found on the manufacturer s web page www microaud com PUB 114 Rev B doc V User s Manual Tympanometer ES TRAM PUB 114 Rev B doc vi Section 1 Introduction 1 1 Becoming Familiar With the Tympanometer This manual describes the principal features and operation of the Micro Audiometrics Earscan Acoustic Impedance Microprocessor as installed on an AFHCAN Cart 1 1 1 Functional Description The tympanometer automatically measures the flexibility of the eardrum the volume of the ear canal and ability of the ear to limit its reaction to loud sounds this response to loud sounds is
16. ction 2 Operation 2 1 Basic Operating Procedures Operating the tympanometer involves using both the on screen displays of the AFHCAN software and the LCD display on the Earscan module 2 1 1 Starting the Tympanometer Initiate tympanometry as follows l If necessary turn on the tympanometer by setting the On Off power switch to the I position Normally the device is left ON From the Add To Case screen press the Tympanometer button The AFHCAN software will bring up the 7 ympanometer screen on the monitor 2 1 1 Calibration The tympanometer should be calibrated once each day before use It does no harm to calibrate with each new patient and to include the calibration data in the case Proceed as follows l 2 On the Earscan module push the CAL button Place the calibration cavity on the probe tip and hold the cable steady during the test testing begins when a good seal is obtained watch for messages on the LCD display once testing starts it takes about 15 seconds for the REMOVE PROBE message to appear on the LCD display Remove the calibration cavity and return it to its container The Tympanometer screen will now have a thumbnail of the calibration data in the left area of the screen The top of the screen will say You have selected NORMAL Tympanometry Note calibration results will also be displayed at the top of the screen If the results fall outside the range of 1 8 to 2 1 milliliters contac
17. ers may be helpful e there are several factors that contribute to an air tight seal between the ear cuff and the ear canal use the right size ear cuff position the probe with respect to the opening of the ear canal move whole probe left and right or up and down as needed to center on the opening of the ear canal align the probe with respect to the ear canal s internal alignment once the hole in the ear cuff is centered in the opening angle the back of the probe up and down or left and right as needed to match the alignment of the ear canal use adequate pressure to seat the ear cuff against the opening of the ear canal e it may be easier to obtain consistent results for a series of tests if the ears are allowed to rest for a few moments between tests e straighten the ear canal by pulling the pinna up and back for adults or straight back for children PUB 114 Rev B doc 17 User s Manual Tympanometer ES TRAM PUB 114 Rev B doc 18 Section 4 Routine Maintenance 4 1 Care and Cleaning In general the Earscan module and cables can be wiped down with a damp cloth Ear cuffs can be cleaned with alcohol surgical soap or disinfectant soap If ear wax or other debris has accumulated in the probe tip it can be removed for cleaning Proceed as follows Figure 16 Close up of inside of probe housing Remove teflon tape from threads Hypodermic Probe tube tip Figure 16 Removing the probe tip
18. g the tympanometer be sure the cable is not pinched or kinked Avoid moving or jarring the cable while the test is underway on the LCD display Earscan module with these four buttons module is installed on AFHCAN cart Earscan module front PUB 114 Rev B doc 2 User s Manual Tympanometer ES TRAM The calibration date on the back of the Earscan module refers to factory calibration not the daily calibration test Figure 2 Earscan module back Tympanometry Probe Connection jacks on right side of Tympanometry probe Earscan module properly connected Figure 3 Earscan module connectors on right side Data cable Power cable Connections on top of Power and data cables Earscan module properly connected Figure 4 Earscan module connectors and power switch on top PUB 114 Rev B doc 3 User s Manual Tympanometer ES TRAM Ear cuffs three sizes Ear cuff fully seated Ear cuff not fully seated on probe tip on probe tip Calibration cavity Calibration cavity installed on probe tip Figure 5 Ear cuffs and calibration cavity 1 1 3 Hardware Controls and Indicators The Earscan tympanometer includes the following controls and indicators e Power On Off switch located on the top of the electronics module used to apply power to the device leave this in the ON position power to the device is normally controlled via the Cart s main power switch e LCD display panel
19. h Max 34 yrs M D ipni pressed the CAL a en aai button on the Earscan module Tympanometry You selected CALIBRATION Tympanometry Please do a calibration first During tests the LCD display on the Earscan module S lt Watch for feedback on is your primary the Earscan display as source of information you do tympanograms Instructions This is a synopsis 1 Remove earcuff if any on probe gt 2 Place probe in calibration cavity em of the procedure for 3 Observe Earscan display doing a calibration i 4 Hold steady while testing full instructions are 2 Remove probe from cavity provided in this manual and in your training Figure 8 Instructional screen for the CAL button PUB 114 Rev B doc 8 User s Manual Tympanometer ES TRAM Removing the calibration cavity completes the calibration test which brings up the screen shown in Figure 9 Note that the system automatically switches to normal tympanometry At this point you could attach an ear cuff to the probe and proceed immediately into the test Indicates Earscan t Goodhealth Max 34 yrs M G module is in normal Moose Pass Clinic H37 tympanometry mode Thumbnails ame d i Tympanometry Calibration results AL N You selected NORMAL Tympanometry EATON The last calibration result of 2 mi was in the normal range of 1 8 can be viewed by clicking on the thumbnail 4 pY to 2 1 mi Watch for feedback on Click on box to add the Earscan displa
20. he box next to the thumbnail to add or remove a green checkmark c press the Save button to save all checked tympanograms into the case 9 Itis standard practice to leave the Power On Off switch on the Earscan module ON set to the 1 position 2 1 3 Fast Tympanogram Fast tympanometry is useful for very young patients who may have trouble sitting still Fast tympanometry is the same as normal tympanometry in all respects but the following e to place the Earscan module in fast tynpanometry mode press the SPEC button e it takes 5 seconds to generate the basic response curve and about 10 seconds for the complete test Once the tympanometer is in fast tympanometry mode follow steps 2 through 9 for normal tympanograms PUB 114 Rev B doc 15 User s Manual Tympanometer ES TRAM PUB 114 Rev B doc 16 Section 3 Clinical Considerations 3 1 Guidelines for Clinical Success A good tympanogram has the following characteristics e results for both the right and left ears have been obtained for the sake of comparison e calibration has been performed 3 2 Common Mistakes Avoid the following e ensure the probe cable is not pinched or kinked as this can reduce air flow to the probe e do not move the probe cable when testing is underway e do not allow the probe cable to contact a source of mechanical vibration during the testing e the act of swallowing can introduce noise and affect the result 3 3 Tips and Tricks The following point
21. is clean see cleaning procedures in maintenance or in the user manual The white tip to which the ear cuff mounts can also be removed for cleaning Refer to the Micro Audiometrics user manual for more information on removing and cleaning the tip In addition check the ear canal for excessive wax or the presence of a foreign body Indicates that the Earscan module is sending its data to the computer Indicates that a calibration tympanogram is underway Wait until the Earscan display says REMOVE PROBE This is the Earscan s normal startup screen It indicates the Earscan module is waiting for the user to push a button to initiate atest This display would appear if the Earscan module were powered up after the Tympanometry screen has been brought up on the AFHCAN Cart Note device is normally left ON Push the IMP button on the Earscan module to initiate a normal tympanometry test SPEC to initiate a fast tympanometry test or CAL io initiate tympanometry calibration Calibration should be performed at least once each day when the tympanometer is used to compensate for changes in atmospheric pressure and temperature Note that the function of the SPEC button has been modified for the AFHCAN installation The audiometry function of the Earscan device is covered in a separate section This message is displayed after the user pushes the CAL button on the Earscan module Remove an ear cuff from the probe tip if necessary and inst
22. jarred or moved it can introduce a considerable amount of noise into the data Figure 11 When taking a tympanogram it is important to observe the following points e do not jar or move the probe cable e do not allow the probe cable to come in contact with a vibration source such as the Earscan module itself e ensure the probe cable is not pinched or kinked Calibration Normals Volume of ear canal 1 9 ml 1 8 2 1 05 390 200 100 0 100 Pressure in daPa Compliance in mi Acoustic Reflex Test Ipsilateral Tone presented at 1000 Hz and 105 dB Tone presented at 2000 Hz and 105 dB w amp Mad bd Cc c co o V ES 2 E Figure 11 Example of noise introduced during calibration Figure 12 shows an example of the Tympanometer screen that appears when you press the SPEC button on the Earscan module A fast tympanogram takes about half the time as a normal tympanogram tent Goodhealth Max G4 yra M Moose Pass Clinic H 37 Tympanometry r gt You selected FAST Tympanometry The last calibration result of 2 ml was in the normal range of 1 8 to 2 1 ml Indicates the Earscan module is in fast Watch for feedback on tympanogram mode the Earscan display as you do tympanograms Instructions 1 Place earcuff on probe 2 Place probe in ear canal 3 Observe Earscan display 4 Hold steady while testing 5 Remove probe from ear Instructions for fast tympanogram are the same
23. layed on the Cart saying that audiometry cannot be done from the Tympanometer screen An audiometry test will be initiated by the device but no audiometry data will be captured into the case If the Tympanometer screen is displayed pressing the CAL button on the tympanometer will initiate a calibration tympanogram On completion of the calibration procedure the tympanometer will automatically switch into the normal tympanogram mode allowing one or more tympanometry tests to be performed in sequence There is no harm in pressing the IMP button but it is not necessary If the Tympanometer screen is displayed pressing the SPEC button on the tympanome ter will place the device in fast tympanogram mode The main difference between a fast tympanogram and a normal tympanogram is the time it takes to perform the test The same basic data is collected 1 1 4 Tympanometer Screen Figure 7 shows the first screen that appears when the Tympanometer button is pressed on the Add To Case screen The screen provides basic instructions at the top and illustrates which buttons to push on the Earscan tympanometer module The on screen buttons are not active Table 3 describes the functions of the buttons on the Tympanometer screen Indicates that the Patient Goodhesith Max B4 wre M next step is to push Cee Anaa Pa Cement one of the three Tympanometry indicated buttons on the Earscan module Log Out A gt TO START Press a but
24. located on the front of the electronics module used to display data Figure 6 as well as the messages generated by the tympanometer refer to Table for a list of messages e Pushbutton controls located on the front of the electronics module only four buttons are active when the device is installed on an AFHCAN Cart refer to Table 2 for functional descriptions E a h a a E O Oo Pressure in daPa Tympanogram data as shown on LCD display Same data as shown on Tympanometer screen Figure 6 Comparison of tympanogram on LCD display and on screen report PUB 114 Rev B doc 4 User s Manual Table 1 Tympanometer ES TRAM Earscan generated messages Message on LCD Display AIR LEAK BLOCK BUSY CALI BRATI NG MP Norm Tymp AUD Audi ometry CAL Cal Tymp SPEC Fast Tymp NSERT PROBE IN CAL CAVITY MI CRO AUDI OMETRI CS EX71A PUB 114 Rev B doc Meaning Indicates that the ear cuff may not be seated fully against the opening of the ear canal To correct the situation ensure the probe is aligned properly with the opening of the ear canal the right size ear cuff is being used and the probe is held in place with a sufficient but not excessive degree of firmness Indicates the opening to the tympanometry probe is blocked This can occur if the opening in the ear cuff is covered or plugged with foreign material such as ear wax To correct the situation remove the ear cuff and ensure it
25. probe tip for the presence of debris and clean as outlined above if necessary PUB 114 Rev B doc 20 Index acoustic reflex BLOCK error message 5 calibration data image 9 cleaning 5 19 defined 1 correctly installed image 4 ear s response function 1 effect of noise during calibration image 10 general reference 2 on screen results image 11 obtaining good seal 17 test duration 14 procedure 5 9 14 test not completed 14 three sizes image 4 test process 1 Earscan module Add To Case screen 7 8 active front panel buttons 6 AIR LEAK message 5 14 audiometry error message 11 AUD button back image 3 error message 7 11 cleaning 19 error message image 11 connectors and power switch on top image 3 in startup display 5 connectors on right image 3 not applicable to tympanometry 5 EPROM version 5 on front panel image 2 front panel image 2 Back button general reference 4 5 6 10 11 13 14 15 function 8 included items 2 on Tympanometer screen image 7 on screen instructions 7 8 BLOCK message 5 14 precaution 10 BUSY message 5 6 14 ready indication 5 6 buttons front panel sending data 5 unused 12 unused buttons on front panel 12 unused image 2 electronics module See Earscan module CAL button functional description See device function function 7 IMP AUD CAL SPEC message 5 on front panel image 2 IMP button on screen instructions image 8 function 6 procedure 5 13
26. s message displays briefly during a normal or fast tympanometry test as the Earscan verifies the probe has a good seal no air leaks and is not blocked Continue holding the probe in the patient s ear gt TESTING lt Indicates a test is underway This message applies to normal or Table 2 fast tympanometry Continue holding the probe in the ear until instructed to remove it Active buttons on Earscan electronics module and their functions Button PUB 114 Rev B doc Function If the Tympanometer screen is displayed on the AFHCAN Cart pressing the IMP button on the Earscan tympanometer module will place the device in normal tympanogram mode impedance mode in Earscan s manual In this mode one or more tympanometry tests can be performed The device automatically senses when the probe has been inserted properly into the ear canal and begins the test On completion of the test a REMOVE PROBE message will appear on the LCD display The message BUSY will appear while the data is being sent to the computer When the data has been sent the tympanogram will appear on the LCD display At this point the device is ready to begin another tympanogram It is not necessary to press IMP again If you do press IMP however the screen will display the instructions for anormal tympanogram User s Manual Tympanometer ES TRAM Button Function If the Tympanometer screen is displayed and the AUD button is pressed a message will be disp
27. t AFHCAN Customer Support At this point you have the following options a click on the thumbnail to view the calibration data b click on the green checkmark to deselect the calibration data c proceed with a normal tympanogram at this point pressing the IMP button is optional See section 2 1 2 d press the SPEC button on the Earscan module to place the device in Fast Tympanogram mode see Section 2 1 3 PUB 114 Rev B doc 13 User s Manual Tympanometer ES TRAM 2 1 2 Normal Tympanogram The following is the procedure for doing a normal tympanogram 1 Press the IMP button on the Earscan module On the monitor the Tympanometer screen will say You selected NORMAL Tympanometry Look at the patient s ear canal and notice its size and alignment Select an appropriately sized ear cuff clean it with an alcohol swab and place it on the probe tip Brief the patient about the test with the following information a you will feel a small change in pressure during the test b at the end of the test you will hear two loud tones they are part of the test c try to hold as still as possible and avoid swallowing during the test Watch the LCD display and respond to messages as appropriate a if the LCD display says Al R LEAK reposition the probe in the patient s ear canal and try to obtain a good seal b if the LCD display says BLOCK remove the probe and check the ear cuff and tip for any wax or other debris and clean
28. ton on the Earscan Please do a calibration first A calibration should be performed once each day to com pensate for changes in atmospheric conditions Start Normal Tympanogram Four buttons are active on the Earscan module but only three Start Fast Tympanogram apply to Recommended for young children tympanomaitry Start Calibration Tympanogram Figure 7 Initial screen for tympanometry PUB 114 Rev B doc 7 User s Manual Tympanometer ES TRAM Table 3 Buttons on Tympanometer screen and their functions Button Function Pressing the Save button saves all selected tympanometry data obtained in Save s i this session to the case and returns to the Case screen Pressing the Back button discards all tympanometry data obtained in this session and returns to the Add To Case screen Pressing any one of the three tympanometry buttons on the Earscan module will bring up an instructional screen relevant to that button The sequence below shows a normal sequence beginning with calibration Figure 8 shows the screen that appears if you push the CAL button on the Earscan module The Earscan LCD display will display a message to place the calibration cavity on the probe Once the calibration cavity is placed the calibration test will begin automatically A trace of the calibration results will be displayed on the LCD display then a message will appear to remove the probe Indicates you have Patient Goodhealt
29. y as you do tympanograms or delete green checkmark which identifies data to be saved in case Instructions 1 Place earcuff on probe The primary result 2 Place probe in ear canal of calibration re 3 Observe Earscan display r 7 4 Hold steady while testing places the advice 5 Remove probe from ear to do calibration This is a synopsis of the procedure for doing a normal tympanogram Figure 9 Instructional screen for the IMP button If you click on the thumbnail of the calibration data a screen similar to the one shown in Figure 10 will appear t Goodhealth Max a4 Ws m a Meow Pasa Lime H3r The mtii Dane Date 11742005 Time 15 34 39 Labek CALIERATIOH 15 49 Tympanogr am Calibration Upper area identifies lt n A type of data in this K case calibration jaa viia i Volume af ear camal 2 mi re ere 18 2 1 4 with date time if and label Calibration cavity has a fixed volume of milliliters as O i a Preneur indaPa Acoustic Reflex Test Ipsilateral Compliance graph one presented af 1000 Hr amd WS dH Tone presented at O00 Hr and 1045 dH is almost flat except for noise effects irtdanhie Imp dini Acoustic reflex tote tes graphs are also flat esses Label is entered automatically by software LABEL CALIBRATION 15 34 3 Figure 10 Tympanometer screen showing calibration data PUB 114 Rev B doc 9 User s Manual Tympanometer ES TRAM If the probe cable is
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