PSAP or a Hearing Aid? – guest post by Wayne Staab

apples-and-oranges1Personal Sound Amplification Products (PSAPs) are electronic devices that allow an individual to listen better in noisy environments, or for those situations when the signal is not strong enough for a listener, regardless of the reason.  These products are not the same as hearing aids; the Food and Drug Administration (FDA) has issued a guidance document under the Food, Drug, and Cosmetic Act that outlines and identifies applicable legal requirements for hearing aids and for PSAP’s. As defined by these FDA Guidelines, “PSAPs are intended to amplify environmental sound for non-hearing-impaired consumers.  ER135-QSA-BZThey are not intended to compensate for hearing impairment.  Examples of situations in which PSAPs typically are used include hunting (listening for prey), bird watching, listening to lectures with a distant speaker, and listening to soft sounds that would be difficult for normal hearing individuals to hear (e.g., distant conversations, performances).  Because PSAPs are not intended to diagnose, treat, cure or mitigate disease and do not alter the structure or function of the body, they are not devices as defined in the Food, Drug and Cosmetic Act Guidelines.”  (FDA, 2009)

The FDA defines the PSAP by “use,” from hearing aids in that:

TermsofuseA hearing aid is a wearable sound-amplifying device that is intended to compensate for impaired hearing.  A PSAP is a wearable electronic product that is not intended to compensate for impaired hearing, but rather is intended for non-hearing impaired consumers to amplify sounds in the environment for a number of reasons, such as for recreational activities.  While some of the technology and function of hearing aids and PSAPs may be similar, the intended use (emphasis added) of each article determines whether it is a device or an electronic product.  The intended use may be established by labeling materials.  Promotional materials that make claims or suggest the use of a PSAP for hearing impaired consumers, such as in the description of the types and severity of hearing loss, establish an intended use that causes the product to be a device and therefore subject to the regulatory requirements for a hearing aid device, as described in this guidance.”

The FDA Guidelines further this differentiation by stating that while hearing aids and PSAPs both affect our ability to hear sound, the products have different intended uses, and are therefore subject to different regulatory controls.

The Lines Separating PSAPs and Hearing Aids are Becoming More Blurred

blurred-visionWhile initial (and many today) PSAPs were very basic sound amplifiers, the market is now seeing improvements in sound quality, cosmetics, functions, sound adaptive features and/or amplification, and noise cancellation.  Essentially, many of the features of hearing aids are being incorporated into PSAPs to improve their performance and cosmetic appeal.  So, from a functional point of view, the devices are becoming more similar.  The primary differentiation relates to the conditions and definitions under which they can be sold.  Essentially, the PSAP has to disassociate itself from the hearing aid attributed functions of compensating for reduction in measured hearing sensitivity.

Consumer Confusion

Today there are hundreds of PSAPs in the market place and even a greater number of hearing aids.  How does the consumer determine which is being sold?  There are a number of things to look for:

  1. What is the product called?  If described (called) a hearing aid, it is a hearing aid.  If advertised as a PSAP, it is a PSAP
  2. Who is selling the product?  If by an audiologist or hearing aid dispenser (hearing professional), it is most likely a hearing aid.  If over-the-counter, Internet, or mail order, it is most likely a PSAP.
  3. Was a hearing test conducted?  If so, the product being purchased is most likely a hearing aid.  If not, or if asked to check listening experiences from a list, it is most likely a PSAP.
  4. Price.  If the product has a cost from approximately $15 to $650 per unit, it is most likely a PSAP.  If the cost ranges from approximately $1000 to $3000 per unit, it is most likely a hearing aid.
  5. Is the product defined to compensate for hearing loss?  If so, it is a hearing aid.  If the term hearing loss (or similar terminology related to loss of hearing) is avoided, the intent is to present the product as a PSAP.

Adding to the confusion is that the hearing aid and PSAP often look the same.  Some PSAPs actually were hearing aids in their “previous” life, having lost their sales appeal, or reinvented to fit the sales requirement of a PSAP.  In truth, any hearing aid could become a PSAP, but not all PSAPs would qualify to become quality hearing aids to be sold by the professional hearing community. Additional information about PSAPs can be found on the Hearing Health and Technology Matters Internet Blog Site hearinghealthmatters.org.  Just type “PSAP” in the search box to access multiple posts about PSAPs.

Staab1Dr. Staab is an internationally recognized expert in the hearing health care discipline.  He is President of Dr. Wayne J. Staab and Associates, a marketing, research, educational, publishing, manufacturing, and consulting organization, and also a founding partner/editor of Hearing Health and Technology Matters, an International blog site for hearing. Educated with a Master’s degree in Audiology and Doctoral degree in Hearing Science, he has held both academic and corporate positioned in the hearing industry. Dr. Staab specializes in hearing and hearing aid related issues, authoring numerous books, articles, and book chapters.

References

Guidance for industry and FDA staff.  Regulatory Requirements for Hearing Aid Devices and Personal Sound Amplification Products, Document issued on: February 25, 2009, U.S. Department of Health and Human Services Food and Drug Administration Center for Devices and Radiological Health, Ear, Nose, and Throat Devices Branch, Division of Ophthalmic, Neurological and Ear, Nose, and Throat Devices Office of Device Evaluation

Posted in Guest Blog Posts, Hearing Assistance Technology | Tagged , , , , , , | 2 Comments

What do YOU want on your BLOG-burger?

burgerWith nearly 1,500 fabulous subscribers, those of you reading this post are the key to the continued success of my Audiology Blog and your feedback is really important!  Think of this survey as a quick drive-thru experience at your favorite fast food place where I am asking you “What would you like on your Blog-Burger?”  Please take a tiny break from your busy day and click on the link below to answer 10 quick questions so I know how to better serve you in the future!  Taking the month of August off and will be back in action on Wednesday, September 4, 2013!  Have a safe and happy summer!

http://aubankaitis.polldaddy.com/s/what-do-you-want-on-your-blog-burger

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What Does a Zephyr Have to Do with Audiology?

24147The word “zephyr” means a lot of different things to a lot of different people.  There is a city north of Toronto called Zephyr in the province of Ontario. Zephyr is also a name of a rock band, a hit song (The Zephyr Song) by Red Hot Chilli Peppers, a computer game developed by New World Computing, and the 6595_35code word for lung cancer first used in 1957 by British American Tobacco in internal documents.  There is a AAA Pacific Coast League minor league baseball team called the New Orleans Zephyrs. In addition, the beloved elephant Babar has a monkey friend whose name is Zephir, although spelled a little differently but you get the gist. So what does the Zephyr mean to audiologists?

Dog-Fan-BlowingWithin the hearing industry, the Zephyr is a popular and effective electric hearing aid dehumidifier integrating three key elements for removing moisture from hearing instruments: 1) moving air, 2) heated air, and 3) a desiccant. It is equipped with an electrical fan that not only moves the air around within its closed compartment, but also heats up the air, making the air molecules more susceptible to adsorption. The desiccant (Dry-Brik II) used by the Zephyr pulls moisture from the warm, circulating air during an 8-hour operating cycle. It is a smaller, less expensive model than the Dry & Store Global II but works the same way with the exception that the Zephyr does button_moisturenot have a germicidal UV lamp whereas the Global II does. The Zephyr is perfect for travel not only because of its smaller size but because it is equipped with a universal AC adapter that can be used anywhere in the world (100-240 volts) with the appropriate plug adapter.  So, if you have a patient whose hearing instrument is plagued with moisture retention issues, try using the Zephyr by Dry & Store (available from Oaktree Products). If have never seen the Zephyr and you are an audiologist, click here!

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SUPER Savings on Summer Staple for Hearing Instrument Wearers

blue beadSince there are approximately one gazillion (more than a million but less than a billion) different hearing aid dehumidifiers or “dri aid kits” currently available in the market, generating excitement about yet another new dehumidifier is not easy. The relatively new DRY-ALL dehumidifier doesn’t offer any technological advantage over comparable products; quite frankly, it works just like any other dri aid kit that houses beads loosely in a jar.  Just like other products, the DRY-ALL is composed of a small quantity of blue pellets that indicate when the beads in the jar need to be reactivated.  Reactivation of the beads occurs via standard procedures with either a conventional oven or microwave.

listen to meSo, what makes this product worth your while and attention?  It will save you and your patients a lot of money.  The DRY-ALL costs $5.40 less per jar than the popular Super Dri Aid utilizing the same molecular sieve technology.  In other words, buying the typical six-pack will save you $32.40.  Not a bad chunk of change for you to save, right? If you currently have your patient’s using loose-bead dri aid kits, give the DRY-ALL a try; not only will you provide your patients the same level of hearing aid moisture removal, but you will do it at a much more affordable price! For more general information on types of dri aid kits, see my previous blog post on Recharging Desiccants from July 20, 2011.  Also, check out the quick one minute video on Recharging a Desiccant via the Oaktree Products YouTube page.

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Amplified Stethoscope & Hearing Instruments – Current Solutions

solutionHearing instrument wearing healthcare professionals performing auscultation procedures as part of their job requirements often turn to their audiologist to find an amplified stethoscope solution that will not only amplify the breath and/or heart sounds they need to hear, but will enable them to keep their hearing instruments in the ears. Recently, the Audiologist’s Choice Bluetooth Amplified Stethoscope (AC-Scope) was commercially made available and initially demonstrated great promise. Unfortunately, the device was plagued with signal transmission issues that either precluded necessary pairing between the AC-Scope’s amplifier and the hearing instrument streamer or, even when successfully paired, resulted in intermittency sufficient to interfere with performing clinical procedures. So, back to the drawing board for the AC-Scope and back to the $100,0000 dollar question: what is the best amplified stethoscope solution for healthcare professionals with hearing loss who are current wearers of hearing instrumentation?

recommendBased on conversations with colleagues who have been working directly with patients in this area, here are the current suggestions as to how to proceed with potentially identifying a viable amplified stethoscope solution for your hearing instrument wearing patients.  Keep in mind, there isn’t one solution that will work with every patient; unfortunately, there will also be instances were none of the suggestions will work for a particular patient. It is best to be prepared to offer at least two (if not all) of the following options:

FOR RIC or OPEN-FIT BTE WEARERS:

1. Try any one of the commercially available stand-alone amplified stethoscopes designed for non-hearing instrument wearers (i.e. 3M Littmann, E-Scope II with traditional earpieces, Adscope, or Thinklabs DS32A) and have the patient attempt to use the stethoscope with hearing their instruments remaining in the ears. Many patients may not be able to tolerate the use of traditional stethoscope earpieces with hearing instruments in the ear however, some patients may and it is worth a try.

2. Invest in the modified E-Scope II with headphones (model #718-7710); hearing instruments remain in the ear while the user places the headphones over the ears during auscultation procedures. If feedback is an issue, the E-Scope II with oversized headphones

718-77103. If the hearing instrument wearer uses a streamer, invest in the E-Scope II with headphones (model #718-7710) along with the necessary E-Scope patch cord (item #711-7129) to hardwire the E-Scope II directly to the streamer. This configuration will require the use of a standard audio-in cable typically packaged with the hearing instruments’ streamer.  In addition, the headphones that come with the E-Scope II will not be used by the patient during auscultation procedures but come in handy during the fitting procedure; when working with the patient, the audiologist can wear the headphones to listen-along as the patient performs auscultation procedures to get a better idea of not only what the patient needs to hear, but to possibly assist in cuing the patient as to what to listen for while making informed decisions as to how to best program the hearing instruments specifically for this type of listening activity.

NOTE: in either situation, it will most likely be necessary to re-programming the hearing instrument to ensure the low-frequency auscultation sounds of the lungs and heart can be detected. For more detailed information, sign up for the free-to-view webinar on Amplified Stethoscope Options for Hearing Instrument Wearers via Audiology Online.com

FOR CUSTOM HEARING INSTRUMENT WEARERS:

1. Replace traditional stethoscope earpieces with special adapters called stethomate tips; success rate is very low but may work.

2. Have special earmolds designed to serve as an interface between the custom hearing instrument and the stethoscope earpieces.

3. Invest in the modified version of the E-Scope II amplified stethoscope with headphones (model #718-7710).

If none of the above solutions work, the only other option is to remove hearing instruments and to use a stand-alone amplified stethoscope during auscultation procedures.

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Ten Tips for Audiology Students on Making the Most of Your Summer Break – guest post by Lana Joseph

As I am finishing up my second year as an AuD student at Washington University School of Medicine in St. Louis, I wanted to share my top ten tips on how AuD Students can make the most of this summer break!

syllabus#1. Get ahead in your reading. Try not to wait until the beginning of the new semester to order your textbooks for next semester’s classes. Email your professors and ask them for a list of textbooks. You may also request a copy of the most current syllabus for that course so that you may gain an idea of the topics covered, mandatory projects, and reading assignments.

katz#2. Order the Handbook on Clinical Audiology edited by Drs. Katz, Medwetsky, Burkhard & Hood. You can purchase this textbook through Amazon.com which offers the book in both used and new conditions, ranging in price from about $50.00 to $72.00. This handbook contains all of the ends and outs on Clinical Audiology. It is a great reference tool for most topics in our field and a must have for your Audiology library.

tm#3. Purchase a pocket otoscope: The summer is a great time to practice your clinical skills. Purchase an otoscope and look in as many ears as possible to improve your otoscopy skills. Your pocket otoscope may also come in handy in clinic during the semester. Oaktree Products Inc of St. Louis, Missouri offers a variety of affordable pocket otoscopes that are perfect for student use. Be sure to ask them for a student discount as they often extend one knowing how tight money can be during this time in our career!

read#4. Read Audiology Magazines. Professional audiology magazines such as The Hearing Review, Audiology Practices, and Audiology Today are great audiology magazines that keep us well-informed on the most current happenings in our field. Since school obligations often keep us from reading professional magazines during the semester, the summer is a great time to catch up.

practice#5. Practice your Clinical Skills. While you are at clinic this summer, spend time practicing your diagnostic skills with the audiometer and tympanometer. Practice Real Ear Techniques and programing hearing aid devices. Become more familiar with the equipment so that you may be better prepared when the semester begins.

network#6. Meet Audiologists in your local area. It is never too early or too late to start networking. Contact Audiologists within your local area and ask them if they would be willing to meet with you to discuss their own journey to Audiology, and also share with you helpful advice.

Tree-of-help-community-service-23891711-300-442#7. Find Research Opportunities. Take time to discover your passion in audiology and begin to research topics in research related to your interest.

#8. Engage in community service activities.  So many individuals are in need of audiological help within our local communities, whether needing to be educated on hearing conservation or needing actual hearing screenings.  By taking time to inform people of what you do, you are promoting the importance of our field while ultimately improving someone’s health.

#9. Apply for scholarships.  Take time to apply for scholarships online. Also email your advisors about potential scholarship opportunities.

Google-search#10. Begin the externship search.  Search for externship opportunities. It’s never too early to conquer the externship search. Third year flies by very fast. It will be time for you to submit applications before you know it.

So what are you doing during this summer to make the most of your time? Please share your thoughts and comments in the Feedback Forum by scrolling to the bottom of this post and entering your thoughts in the box with the heading LEAVE A REPLY.

lanajosephLana Joseph is a second year Doctor of Audiology student at Washington University School of Medicine in St Louis, Missouri. She earned a  Bachelor of Science degree in Chemistry from Nicholls State University in 2009 and a Master of Science in Health Care Management from the University of New Orleans in 2011. Lana is the author of her own Audiology blog called The Audiologist to Be.Com.

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All work & no play….

allworkI have always enjoyed reading Stephen King novels; one line from his thriller The Shining resonates with me to this day: “All work and no play makes Jack a dull boy”. There is something to be said about this infamous quote; I actually referenced it when offering some advice to AuD and Speech-Language Pathology students during the University of Cincinnati’s Spring Banquet this past April (see #10 in  my blog post Advice to Audiology & Speech Language Pathology Students).

gaspAs a recovering workaholic (I used to work all the time!), I made a conscious decision this past New Year’s Eve to plan for more fun and to experience personal challenges that had nothing to do with Audiology. Gasp! Did I really say that? Yes, I did! I will admit, sometimes planning for fun can be a little work but it has definite pay-offs. So, in the spirit of finding balance in life, rather than offering an Audiology ToTT (Tricks of the Trade), information on a new hearing assistance technology, or infection control insight, I offer you a glimpse into my personal life as offered in my other blog called  A.U.’s Adventures.

Play_TimeIt all started with a life-changing trip to Sri Lanka in December of 2012 followed by an Oscar Adventure, and the Whole30 Adventure amongst others.  This past weekend, I started my Alaska Adventure; this is something I always wanted to do and never followed through until now. I hope that when you read about some of my adventures, you will commit to making sure you make time for some of your own, outside of work. This personal exercise has made me not only a better person, but a more productive audiologist.

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Must-Have-Device Makes Audiology Clinic Life Easier

wishDo you wish you had something on-hand that would allow you to communicate with non-hearing instrument wearing patients without needing to speak loudly (so that others can hear)? Wish you could demonstrate to your patients what it’s like to hear in a looped environment or what a t-coil brings to the table? Need to find an affordable solution for a patient with hearing loss that isn’t ready to pursue hearing instrumentation AND you want to be able to adjust the balance? Do you wish I would get to the point?  If you answered yes to any of these questions, consider the newly updated Comfort Duett, an affordable, personal listening device that will allow you to accomplish all of the above plus more.

For Those of You Unfamiliar with Comfort Duett:

Duett w earphones headphones and charging stand USThe Comfort Duett is a user-friendly personal listening device that may be used by both non-hearing instrument wearers (via headphones or earbuds) and hearing instrument users (via neckloop and the hearing instrument’s t-coil).  The device is equipped with a microphone for amplifying conversations and a built-in telecoil that allows users to listen in looped-environments.  It may be connected to the TV, telephone, radio or other sound source with optional accessories. The Comfort Duett comes packaged with two rechargeable AAA NiMH batteries and a charger however, it will also operate on two AAA standard alkaline batteries.

For Those Familiar with Comfort Duett: New versus Original Comparison

The newly updated Comfort Duett (left) obviously looks different from the original device (right) but it also offers from new or improved features that you will definitely appreciate.

comfort audio newand old

The newer Comfort Duett offers digital signal processing with automatic gain control whereas the original version did not.  In addition, the newer model allows for adjustments to be made and then set to tailor to the user’s needs.  Maximum volume levels may be set to prevent the volume from being turned up to loud by accident.  The balance between the right and left ears can be adjusted to accommodate differences in hearing between the ears.  The newer Comfort Duett offers tone control and a lock feature that deactivates key functions to ensure the device stays on at set levels.

Why Consider Investing in a Comfort Duett?

  • Have a Comfort Duett on hand in the office to offer your patient’s a means of hearing you better in the event they are not current wearers of amplification or are having their hearing instruments serviced.
  • Loop your counseling room and allow patients to experience a looped-environment in order to make informed decisions about t-coils.
  • Offer the Comfort Duett as a communication solution to patients who are not willing to invest in hearing instruments or who are looking for an affordable back-up solution
  • Just try it….I think you (and your patients) will like it!!
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