GUIDELINE 1: EAR IMPRESSIONS AND EARMOULD FOR CHILDREN

Transcription

1 GUIDELINE 1: EAR IMPRESSIONS AND EARMOULD FOR CHILDREN PERFORMANCE CHECKLIST Appointments Are ear impressions taken every two to three weeks for children under six months of age? Are ear impressions taken frequently in children over six months of age? Are children able to have ear impressions taken within two days of a decision being made that new moulds are required? Is impression-taking easily accessible to parents and children? Can impressions be taken: in open access clinics? in outreach clinics? at domiciliary visits? at regular appointment times? by other agencies after appropriate training? MHAS Site Starter Pack - Page 31

2 People taking ear impressions Are impressions always taken by experienced personnel who are used to handling babies and young children? Are Teachers of the Deaf or other appropriate personnel trained in otoscopy and impression taking to facilitate speed and access for parents and children? Impression-taking techniques Is otoscopic examination carried out to ensure there are no contra-indications to impression taking? Is a paediatric otologist or ENT consultant available to cope with babies and children who present with contraindications to impression taking (particularly wax removal) or are there arrangements for speedy referral and action? Is the standard procedure for taking ear impressions, recommended by the BSA in 1986, together with the BSA notes on Current Practice and Technology (1994) followed for each impression taken? Are cotton blocks used for babies and young children rather than foam otostops? Are these trimmed to an appropriate size? Is an appropriately small syringe with small nozzle diameter used rather than the standard audiological syringes? For babies under 3 months of age, or for any child with very narrow external auditory meati, do you use a dental syringe with a curved disposable nozzle that can be cut to any diameter? Do you use a medium bodied, addition cured silicone impression material (eg Starkey Precise, Dreve Otoform A/K, Phonak Phonasil, GN ReSound Detax Flexitime ) with an accurate measurement of catalyst and base? MHAS Site Starter Pack - Page 32

3 If condensation silicone impression material is also used in the same location, are there dedicated sets of impression tools for each type of material to avoid cross contamination? Do you use light pens with meatal depth marked on the probe tip? Are the baby s hearing aids available and positioned on the pinnae before the impressions are taken? Are open jaw techniques used with older children whenever possible if there are recurring feedback problems to provide more accurate impressions? Sending impressions to manufacturers Are clinicians experienced in making appropriate judgements about earmould material, earmould type, tubing thickness, specialised tubing and lubricants to ease fitting and removal? Are rigid boxes used for packaging earmoulds? Do you use distinctive dispatch labels which identify the impressions as paediatric and urgent for rapid manufacture? Are earmoulds dispatched on the same day they are taken? MHAS Site Starter Pack - Page 33

4 Manufacture of the earmoulds Do you have regular contact with your earmould manufacturer including dialogue about difficult to fit cases and problems with impressions? Do you have an agreement with your earmould laboratory to prioritise paediatric earmould impressions? Is there no longer than 36 hours (excluding Saturdays and Sundays) turn around time? Are earmoulds available in a variety of colours and decorations? Are finished products dispatched to any given address (eg parents, Teachers of the Deaf) using First Class post? Fitting earmoulds Is there immediate notification (by telephone or similar) to families when new earmoulds arrive back at the hearing aid centre, and an appointment within 24 hours arranged for fitting when this is deemed appropriate? Where tubing retention in silicone moulds is a problem do you use tube retention enhancements such as metal or plastic tube locks, anchor connectors and gluing tubes in with silicone? Do you try double bend tubing to help avoid the problem of the angle of tubing forcing the mould out of the ear when connected to the hearing aid? If the earmoulds are fitted by the child s Teacher of the Deaf, are the earmoulds dispatched to him/her direct from the manufacturer, for fitting to the child within 24 hours? MHAS Site Starter Pack - Page 34

5 Are parents shown how to fit new earmoulds? Are the moulds dispatched directly to the family from the manufacturer to make it quicker and more convenient for the parent? Are parents shown how to retube earmoulds and are they provided with the necessary equipment to do so? Are teachers shown how to retube earmoulds and are they provided with the necessary equipment to do so? MHAS Site Starter Pack - Page 35