1. Spring 2015 INFANT HEARING PROGRAM: Introducing the AccuScreen In-service

2. ACCUSCREEN – Getting Started The AccuScreen is a touchscreen unit that has the capability to screen using Automated Distortion Product Otoacoustic Emissions (ADPOAE) or Automated Auditory Brainstem Response (AABR) or both, depending what the configuration is. The AccuScreen is a hand-held, battery powered unit that can be charged in the docking station. The battery will be fully charged after six hours. A full charged battery will last eight hours, depending on use.

3. Caring for the equipment What pieces are disposable? What is the easiest way to maintain equipment? Can we prevent breaks? -Hold equipment carefully, to avoid dropping it. -Keep wires tidy, avoid knots. -Insert connections into the correct ports. ACCUSCREEN – Getting Started

4. To self calibrate insert the probe into the back of the unit. To turn it ‘on’ press the grey button on the side of the unit, press and hold the bottom of the button to turn it ‘off’. To remove the battery (reboot or change battery) press the battery release and the back will open. On Battery Probe Test Battery release

5. ACCUSCREEN – Getting Started Home page Find a Patient Create a New Patient View the Tests Print the Tests Delete Patients Quick Test to check your hearing Quality test to troubleshoot Settings to change i.e. date, time, log in

6. ACCUSCREEN – New Patient We do not store personal health information without encryption. Select New Patient to get a new ID and perform the test.

7. ACCUSCREEN – New Patient To enter a numerical ID touch ‘123’ to switch from ‘aaa’. Touch the checkmark after you entered the desired number.

8. ACCUSCREEN - Probe Tips and Eartips There are five disposable eartips available for use with infants; 3.7mm yellow, 4.0mm green, 4.5mm pink, 5.0mm blue and the transparent tree tip 4-7mm. A clean eartip must always be used when placing the probe tip into the ear canal. Probe Tip Eartip

9. ACCUSCREEN – Connecting the probe tip Click the probe tip onto the speaker cable, then slide the appropriate sized eartip on. To remove hold the probe tip at the top and bottom along the groves, push together then outward.

10. Babies NOT at Risk A two step process. Step one with ADPOAE equipment. Step two if needed with AABR equipment. Step two should be done as soon as possible to reduce parental anxiety. IHP – Stage One Screening

11. DPOAEs are generated by the outer hair cells (OHCs) of the cochlea. Normal DPOAEs usually mean that hearing is normal (at the time of screening…) Absent DPOAEs suggest that hearing may be abnormal and further testing is needed. IHP – Stage One Screening

12. Infants will either receive a pass or a refer result. A pass means that the baby is hearing at this time. But, it is always important to monitor. A refer does not necessarily mean that the infant has a hearing loss. Commonly, debris in the ear canal, fluid in the middle-ear or movements during the test will affect results. A referral to another stage of screening is needed. IHP – Stage One Screening

13. ACCUSCREEN – ADPOAE The hearing screening is a quick, easy, non-invasive screening test that does not involve the performance of any of the controlled acts under the Regulated Health Professions Act, 1991. Provision of parental consent is required, unless hearing screening is performed as part of a hospital’s standard of care. Consent to share results with the regional IHP is always required.

14. ACCUSCREEN – ADPOAE To screen with the ADPOAE connect the cable with the blue base. Ensure the arrows are aligned properly. Select an appropriate eartip. Put on the probe tip and eartip. Select the ear for initial screen.

15. ACCUSCREEN – ADPOAE Touch the black arrow to begin. The equipment will calibrate and then initiate screen. The screen is completed once three frequencies have a clear response.

16. ACCUSCREEN – ADPOAE The Test Menu has tests completed and test results. The Test View shows all attempts including missed calibrations and aborted tests.

17. ACCUSCREEN – DPOAE Errors If there is too much noise, reduce environmental noise i.e. turn off cell phones and/or check the ear for debris. You can also try a Quality Test to make sure the probe is OK.

18. ACCUSCREEN – AABR Soft sounds are played in the baby’s ear and the brain’s electrical response is recorded using three sensors (electrodes). The brain’s response to the sounds is automatically analyzed and interpreted by the AccuScreen.

19. ACCUSCREEN – AABR To conduct an AABR, connect both the green and blue cords. Make sure the arrows are aligned properly. The red electrode goes on the right mastoid. The black electrode goes on the left mastoid. The white electrode is placed on the baby’s forehead (high midline).

20. ACCUSCREEN – AABR Touch the black arrow in the Test Menu. Once impedance values are OK, the black arrow is highlighted, touch to start. The testing page will appear. The test is complete when the ABR bar or Progress bar is full.

21. ACCUSCREEN – AABR Errors If impedance values are good, the color will be green. Yellow means that the connection is not as good. Red is unacceptable. A yellow reading can turn red if the electrode is loose or falls off.

22. ACCUSCREEN – Troubleshooting Quality Test Before testing babies each day, a Probe Test should be done. Insert the probe into the test cavity at the back of the AccuScreen. The test will start automatically. Results will appear as ‘Probe OK’ or as ‘Probe failed’ with possible errors.

23. ACCUSCREEN – Troubleshooting Loose Cord Error If your electrodes appear attached but you still get poor impedance or loose cord errors, perform an Electrode Test to check the cables. Attach the electrode cable wires and check with a Quality Test to make sure they give good impedance. The Test results page will indicate the condition of the electrode cables.

24. ACCUSCREEN – Troubleshooting Other Errors and Solutions AABR does not start – press the triangle to start. Black screen – unit powered off (eject battery if needed). Timeout during pause – AABR was paused more than two minutes. Battery Start Not Working? Contact Genie Audio ihpsupport@genieaudio.com Tel: 1-866-788-1830 Request and record the RMA number. Fax or email the completed form.

25. Contact your Infant Hearing Program Regional Trainer or your Infant Hearing Program Coordinator IF YOU HAVE ANY ADDITIONAL QUESTIONS…