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Pure Tone Audiometry

Not Masked Air and Bone Conduction (BSA Procedure)

What level should ambient noise not exceed? 35dB
What should communication strategy take into account? - Age - Hearing level - Language Skills - Attention/Concentration - Other communication difficulties
Audiometry is preceded by... Otoscopy
Insert earphones are used where... ...there is a possibility of ear canal collapse with supra-aural headphones
History taking (audiological) Noise exposure in the last 24 hours - Tinnitus - Recent ear infections / Pain in ears - Surgery to ears at any stage - Which ear is more acute
What two important points should be covered at the start of the consultation? - Verifying patient - Introducing the appointment
What is considered loud noise exposure? Noise in which you need to shout at a distance of 1 meter
How long should the test take? The test should not exceed 20 minutes
Dealing with tinnitus -Subjects asked to ignore tinnitus as much as possible - Inform the tester if experience difficulty (note made)
Instructing the patient - Testing the quietest sounds you can hear -As soon as hear sound, press button - Release when no longer heard.
Press button irrespective of... - Ear it is hear in - How quiet it is
Other important instruction points - Sit still and quietly - Interrupt is uncomfortable or if the need a break
Where should insert earphones not be used? - Excessive wax - Infection - Obstructions - Abnormalities
PTA should test the ......... ear first Most acute (better)
Test order 1000, 2000, 4000, 8000, 500, 250,Retest 1000 if first ear.
If the retest value is less than 5dB different then... The most sensitive value is taken
If the retest value is more than 10dB different then... Reason should be investigated (reinstruction and repeat)
Duration of test tone Varied between 1 - 3 seconds
Interval between test tones Varied between 1 - 3 seconds
Initial familiarisation level 1000Hz at 40dB HL or 30dB above previous audiogram. If no response increase in 20dB steps until response (5dB steps above 80dB).
Example of audiometry: Satisfactory familiarisation Decrease in 10 dB until response
No response Increase in 5dB until response
Response Decrease by 10dB
No response Increase in 5db until response at consistent level >50% of presentations
Which is better: 3 accurate frequencies or 6 non accurate frequencies? 3 accurate frequencies
I am ommitting frequencies or modifying the test I must note on the audiogram/journal
The bone conductor is placed on the... WORST hearing ear (noted on audiogram or journal)
Points on position of bone conductor As close to the pinna without touching it and with no hair obstruction
Test order 1000, 2000, 4000, 500
Instructions Same as A/C but with emphasis on irrespective of side
At ......Hz the signal presented by the bone conductor may conduct by air conduction, what should be done? 4000Hz and a plug should be placed in NTE
What is the other major source of error in bone conduction? Vibrotactile threshold
Normal -10 to 20dB HL
Mild 20 to 40dB HL
Moderate 40 to 70dB HL
Severe 70 to 90dB HL
Profound Above 90dB HL
Created by: Youworktoohard