As stock of infection control supplies stabilize, the demand for some key products continues to outpace supply. For example, COVID-19 disrupted manufacturing operations, creating large-scale bottlenecks in the production oflarge AudioWipes™ canisters throughout most of 2020. While the situation has been challenging, it demanded a solution and necessary steps were taken to make large canisters of AudioWipes available without compromising quality and/or increasing price to the provider.
What is DIFFERENT?
Canister size is 1.5″ shorter and 0.5″ wider
Easier-to-pop-open lid
Larger wipe size (6″ x 6.5″) than original (6″ x 3.87″)
Different cloth material than original
What is the SAME?
Formula
Number of wipes (160)
Price to providers
This solution ultimately involved sourcing some things out to different vendors which explains changes in the look and feel of the canister and wipe material/dimensions. While this approach did increase production costs, pricing will stay the same for providers. From that perspective, the revamped large AudioWipes canister currently in-stock may only serve as a temporary stop-gap. That decision will be made sometime in the future; until then, order away as the large canisters ofAudioWipes are back in stock!
SHARABLE COMMUNICATION: A previous blog post offers sample communication to share with patients or parents about cleaning hearing aids with AudioWipes. Click SAMPLE COMMUNICATION for more information.
TO PLACE ORDERS: If you already have an Oaktree Products account, log in at www.oaktreeproducts.com to place your order. Prefer to talk to us or not sure how to log in to your account? Call toll free 800.347.1960 or e-mail us at otp@oaktreeproducts.com. Order by the each or by the case of 12.
If you would like to set up an account with Oaktree Products, click CREATE ACCOUNT.
The year 2020 catapulted infection control to the forefront of clinical practice. The COVID-19 pandemic forced providers to step-up the infection control game because the services we provide are essential. Part of this involves not only using disposable supplies where possible, but treating disposable supplies as intended. For example, immittance audiometry is an essential component of the audiological assessment that requires use of eartips, the majority of which are disposable. While it may be disappointing to learn most eartips are packaged as disposable and intended for one-time use only, integrating disposable ear tips within a clinical protocol is straight-forward and reduces potential for cross-contamination.
To help replenish your supply, Oaktree Products is extending unprecedented savings throughout January 2021 on disposable immittance eartips by offering more than 50% off Sanibel ADI Series and nearly 20% off Grason & Associates*IA, GS, MO, IT, and PM single-use eartips. Why?Because YOU are essential and so are your disposable immittance eartips.
*Grason & Associates KR tips already available at lowest industry prices.
TO PLACE ORDERS: If you already have an Oaktree Products account, go to www.oaktreeproducts.com, log in to your account to see pricing, and place your order. Prefer to talk to someone or not sure how to log in to your account? Contact customer service toll free 800.347.1960 or via email at otp@oaktreeproducts.com.
If you would like to set up an account with Oaktree Products, click CREATE ACCOUNT.
A wide range of microbes (e.g. bacteria, viruses, fungi) grow on hearing aid surfaces1,2 and audiologists and other providers should either clean and disinfect hearing aids prior to handling devices with bare hands, or put on a pair of gloves before handling devices. The COVID-19 pandemic has raised questions about the general efficacy of ultraviolet (UV) light for disinfecting hearing aid surfaces. Is it effective? The short answer: it depends.
There are different categories of UV light with the UVC spectrum (200-280nm) effectively used for surface disinfection. UVC does kill bacteria and viruses although germicidal effectiveness is influenced by several factors including surface contamination with organic matter.3 Since hearing aids are typically contaminated with cerumen, dirt, dust, and/or other particles,4 surfaces must first be cleaned (with tissue or disinfecting wipe) for UVC to inactivate bacteria and viruses.5,6
Bulb strength and the distance between the bulb and surface also come into play.3 Higher intensity bulbs require shorter periods of UVC exposure, whereas lower intensity bulbs require more. In addition, efficacy of disinfection decreases as the distance from the bulb increases. Some manufacturers of hand-held UVC lights (i.e. light wands) claim it takes ten seconds for an average bacterium to be killed at a distance of about six inches,7 however, it’s just not that straightforward. Depending on the product, it may take as many as 30 minutes to kill certain bacteria or viruses because the intensity of the UVC bulb is not strong enough8 and/or the distance between the bulb and surface is too far to render disinfection within claimed time periods.
Bottom line, UVC is effective in killing germs yet most effective when combined with traditional disinfecting methods. Regarding COVID-19, UVC has been shown to destroy the outer protein coating of the SARS coronavirus (SARS-CoV) although it is not same virus that causes COVID-19 (SARS-CoV-2).6 According to the FDA, since UVC does inactivate the SARS-CoV, it may be effective in doing the same to SARS-CoV-2. The main way COVID-19 is transmitted is via droplet contact transmission; although the virus can survive for periods of time on surfaces, the CDC continues to state that transmission via a contaminated surface is not likely nor the main way the virus spreads.9 The best approach is to clean and disinfect hearing aid surfaces with an EPA-approved (preferably non-alcohol based) disinfectant spray or wipe, making sure to follow instructions pertaining to dwell time if the intent is to handle devices with bare hands.
Concluding Insights:
A handful hearing aid dehumidifiers come equipped with UVC lamps including the PerfectDry Lux,PerfectDry Lux Rechargeable for Zpower, PerfectClean, Smart Dryer Li-Ion, Dry & Store Global, Dry & Store DryMax UV. The design of these products places hearing aids at a close and consistent distance from the UVC lamp, offering quick germicidal cycles (90 seconds to 5 minutes) effective in killing certain bacteria and/or viruses. Keep in mind, UVC is limited to line of sight; only those surfaces exposed to the light will be disinfected.10 From this perspective, it is critical to clean and then disinfect hearing aid surfaces with a disinfectant spray or wipe prior to exposing devices to UVC. Depending on the design of the hearing aid dehumidifier, it may necessary to rotate or change positions of hearing aids after the initial UVC cycle and then repeat a second UVC cycle if the goal is to ensure all outer hearing aid surfaces are exposed to UVC light.
Representatives from major hearing aid manufacturers were asked about UVC. As listed in the table below, most did not object to the use of UVC on their products. In the absence of safety data, Starkey did not offer a recommendation while ReSound did not object but added to use UVC at your own risk.
Manufacturer
UVC Recommendation
Product Rx?
Phonak
UVC recommended
Phonak D Dry
Signia
No objection as no known issues for circuit damage from UVC as our components are coated.
PerfectDry Lux
Widex
No objection but check manuals to ensure appropriateness for rechargeable hearing instruments
None
Starkey
No recommendation at this time
None
Oticon
No objection although no claims about COVID-19 can be made; recommend cleaning hearing aids with any wipe that does not contain alcohol with or without UVC
None
ReSound
No objection but use dehumidifiers with UVC cycle at your own risk as ReSound has not yet approved any specific UVC disinfectant cycles
No official recommendations although providers offer positive feedback on PerfectDry Lux and Perfect Clean
Unitron
No objection although recommend use of gloves to clean and disinfect hearing aid surfaces prior to handling hearing instruments using disinfectant wipe.
None
Table 1: recommendations regarding the use of UVC light on hearing aid surfaces from hearing aid manufacturers in regard to any contraindications to the safety of the process on product integrity
Hearing aid dehumidifiers equipped with UVC lamps can be incorporated within the clinic as part of the general maintenance service offering. Providers can place hearing instruments in the unit and run the initial UVC cycle as a supplement to traditional hearing aid disinfecting protocols. This may serve as an opportunity to re-educate patients about proper hearing aid cleaning and facilitate adoption of hearing aid dehumidifiers for home use. For more information on dehumidifier considerations related to Zpower batteries, see the previous blog post Special Dehumidifier for ZPower Charging System.
About the Guest Blogger
Lori Zitelli, AuD is a Senior Audiologist at the University of Pittsburgh Medical Center (UMPC) and Lab Instructor at the University of Pittsburgh. She received her clinical doctorate in Audiology from the University of Pittsburgh. Her interests include amplification, tinnitus treatment, clinical education, clinical research, and interventional audiology. Dr. Zitelli is an active fellow and member of the American Academy of Audiology.
References
Bankaitis, A.U. (2002). What’s growing on your patients’ hearing aids? The Hearing Journal, 55(6), pp. 48-56.
Sturgelewski, S., Bankaitis, A.U., Klodd, R. and Hamberkamp, C. (2006). What is still growing on your patient’s hearing aids? The Hearing Journal, 59(9): pp. 45-48.
Bankaitis, A.U. & Kemp, R.J. (2002). Hearing Aid-Related Infection Control. In: M. Valente (Ed.), Strategies for Selecting and verifying Hearing Aid Fittings, Second Edition (pp. 369-383). New York: Thieme Medical Publishers.
Gostine, A., Gostine, D., Donohue, C., & Clarlstrom, L. (2016) Evaluating the effectiveness of ultraviolet-C lamps for reducing keyboard contamination in the intensive care unit: a longitudinal analysis. American Journal of Infection Control, 44(10): pp. 1089-1094.
If you haven’t heard Dr. Gyl Kasewurm’s story, it is pretty incredible. In her own words…
“In the middle of the recession in 2008 and 2009 I went absolutely broke. I was devastated! I had worked so hard to build my practice and I was confident I knew what I was doing! I had the protocols in place and a great team. So, how could this happen??
Sometimes, things happen that are out of your control. I realized I had to do some things differently. I had to make some changes.
So, I didn’t give up and I learned some new tools and I made a few changes…
What I learned helped me come back stronger and I gained back everything I had lost…and more!”
AND YOU CAN TOO!
This is precisely why Dr. Gyl’s Women of Wonder Network organized the Rise & Thrive Virtual Seminar 2020 on September 10-11. Two action-packed days offering 1.15 CEU (11.5 hours) with 20 amazing speakers will give you the tools to RISE above what is happening in the world and to THRIVE.
Take away actionable, usable, and unforgettable information on topics including:
Finding the Courage to Rise and Thrive
Ways to Rise Above Burnout to Thrive
Using Your Numbers to Rise and Thrive
Women in Business – Using the Right Tools
More than a Manager – How to Get Employees to Like You and Rise to the Occasion
Infection Control – Rise Above COVID-19 Noise
Panel discussions will also help navigate important issues of the current day including How to Rise Above Issues Affecting Women and The Importance of Girlfriends – Strength in Numbers.
REGISTER to reserve your seat now! First 100 registrants get a Dr. Gyl Swag Box (some packed with some pretty cool surprises)! The event starts on Thursday, September 10:00 at 10 AM EDT via an online Facebook Live Stream. Attendees will be invited to Private Facebook Group for the event. See you there!
Registration Fee information for Live Attendance, Live & Recorded CEU Access Through December, or All-Access Pass here.
As a graduate audiology student with cochlear implants, I struggled with performing listening checks on hearing aids because traditional listening tubes route signals through the ear canal. I tried attaching tubing to FM systems and remote microphones but listening to hearing aids via a second amplifier made it difficult to perform subjective assessments with acceptable accuracy. Eventually I settled with plugging a lapel microphone into the DAI port of my processor and using double belled tubing to couple the lapel microphone to the hearing aid receiver. This worked up until I switched to a new cochlear implant processor that no longer supported this configuration.
Out of frustration, I started contacting earmold manufacturers to share my story, hoping to find someone willing to move the sound bore from the ear canal to one of the microphones of my cochlear implants. This is how I connected with Michael Harvest of Pacific Coast Laboratories. We worked together on creating a solution for me which resulted in what we both called the very first “Laura Listening Tube”. I was floored by the sound quality and how easy it attached to my processor. This configuration provides more natural sound as the listening tube does not re-amplify the hearing aid’s output like other listening tube solutions I’ve tried.
After sharing my experience on some Facebook pages, other students and audiologists with hearing loss reached out and worked with Michael at Pacific Coast Laboratories to create a customized listening tube. As a result, several different listening tubes inspired by the first “Laura listening tube” are now available for different cochlear implants and BTE hearing aids. If one is not currently available for your specific device, you can send in an impression of your cochlear implant or BTE using a non-functioning replica provide by the device manufacturer.
Ordering Your Own Listening Tube
Send an email to Leigh of Pacific Coast Laboratories at Leigh@shoppcl.com. Be sure to include the following:
In the subject line of the email, type in “Listening Tube for Cochlear Implant/Hearing Aid”.
In your email, include the specific model of your cochlear implant or hearing aid.
If an impression has already been made for this model, you just place an order for the listening tube.
If an impression has not been previously made for the specific model of your cochlear implant or hearing aid, contact your local manufacturer’s representative to explain the need to make an impression of your cochlear implant or hearing aid to pursue a customized listening tube. The manufacturer should be able to send you a non-functioning replica to make the impression.
Payment required at the time of order; call (510) 351-2770 to relay credit card information.
Making an Impression
Using earmold impression material and the non-functioning replica, cover the entire panel where your hearing device’s microphones sit and cover the microphone(s) with impression material. Then cover the sides of the device connected to the already covered microphone panel, but do not add impression material all the way around the device (see picture below). Like a normal earmold impression, you do not want gaps or air pockets in contact with the non-functioning replica. Let impression material harden fully.
Gently peel impression material off the replica. Mark the microphone’s indentations with a light-colored permanent marker and be sure to tell Michael that these marks indicate the microphones. If your hearing device only uses the second microphone in certain situations, please indicate which microphone you would like the listening tube sound bore to go to.
Make a second impression except this time include impression material all the way around the replica (making a tube). Let the impression material cure. Make a cut on the underside of the replica and remove the replica.
Send both impressions to Michael.
While not required, it could be beneficial to email pictures of your hearing device with and without the impression material on it, so that Michael has an indication of size/direction of your hearing device.
About the Guest Blogger
Laura Schauer, AuD is an audiologist with a passion for improving the quality of life for those with hearing loss and spreading awareness about the profession. She received her AuD from the University of Northern Colorado in May of 2020. She has recently relocated to California from her home state of Colorado to work in a private audiology practice. For more information, contact her directly at laura.schauer44@yahoo.com.
The ClearMask is comprised of a rectangular piece of anti-fog plastic film with two individual foam pieces (see A and B in the figure on the right) adhered on the inside portion of the mask. The thinner foam piece (A) is the top of the mask and has a nose cutout (C). The more substantial foam piece (B) is the bottom and designed to rest the chin. The EZ-Adjuster version of the ClearMask has a continuous elastic strap (D) that loops at the top and bottom with the EZ-Adjuster located on the bottom strap (E). The top and bottom straps are designed to be placed over the head and positioned above and below the earsrespectively. The EZ-Adjuster is then used to adjust the mask by pushing inward to tighten the straps.
Since the availability of this product, it makes sense to share the four most frequently asked questions about the ClearMask to offer clarification to those who have ordered or are planning to order the product from Oaktree Products.
How do I don the ClearMask?
Perform hand hygiene
Peel protective layer on outward-facing side of mask
Position the mask in your hand with the foam facing inward and the nose cutout on top, towards your fingertips. Bring the mask toward your face, such that your nose fits into the nose cutout and your chin rests on the bottom foam piece
With the other hand, take both the top and bottom straps and placed them over your head. The bottom strap sits at the base of the head, below the ears. The top strap rests higher at the back of the head, above the ears (do not crisscross straps).
Use the EZ-Adjuster in the back to adjust the mask by pushing inward to tighten or pulling outward to loosen the straps.
The 20-second video below will quickly show you how to put the mask on. Click HERE for written instructions.
Is it reusable?
As with any mask intended for use in clinical settings, the ClearMask is designed and labeled for single-use only and is not intended to be reused. With critical mask shortages due to COVID-19, the FDA and CDC have issued some interim flexibility about masks in general, indicating extended or limited reuse of masks in some cases (see Masking Dilemma). Check with public health authorities within your state and/or institutional authorities regarding extended or limited reuse of masks.
Does it fog up?
The plastic shield has an anti-fog coating that minimizes fogging when the wearer is speaking or breathing.
Does this mask come in different sizes?
The ClearMask is one size and designed to fit adults’ faces.
Wearing a mask is necessary to minimize the spread of COVID-19. Unfortunately, solid masks covering the mouth introduce significant obstacles for the nearly 40 million Americans with hearing loss. Depending on the type (e.g. medical vs N95), masks attenuate high frequency speech sounds by 3dB to as much as 12 dB.1 Furthermore, solid face masks hide facial cues, including lipreading which facilitates speech comprehension.2 Basic communication strategies like speaking slowly and reducing ambient noise remain key however, integrating personal protective equipment (PPE) maximizing full-face view becomes a more important issue in the audiology clinic. Procedural masks with clear windows offer visual access of the mouth although window masks are also subject to limitations including insufficient window size and fogging of the window.3,4 The new EZ-Adjuster style ClearMask™ addresses these issues and represents a promising PPE solution for audiologists and other providers/staff to consider.
Designed to block aerosols, fluids and sprays, ClearMask™ is the first fully transparent face mask offering full view of the face. The primary integrated barrier is an anti-fog and anti-glare plastic. It straps over the head and adjusted at the back of the head using the EZ-Adjuster for a customized fit. Since the mask is secured at the back of the head, it eliminates the problems hearing aid or cochlear implant wearers experience when using masks with ear loops, including frustration of losing devices when doffing masks. The patent-pending design optimizes comfort and breathability, while providing the protection a mask is intended to provide. Conditional FDA approval positions ClearMask™ as the preferred clear mask of choice in the clinical setting. Contact Oaktree Products toll free 800.347.1960 or via email at otp@oaktreeproducts.com.
Additional Reminders:
Aerosol generating procedures require the use of N95 or KN95 masks with eye protection; for a basic review, see the previous blog post Masking Dilemma.
When no face masks are available, the use of a face shield that covers the entire front (extending to the chin or below) and sides of the face with no face mask is an option.5
ClearMask™ is also available in the classic tie-on style; Oaktree Products only offers the EZ-Adjuster Style (item# CM24).
Refer to ClearMask™ EZ-Adjuster Instructions for Usefor a quick but important video on how to properly use the EZ-Adjuster; the ClearMask™ does close around the face when the EZ-Adjuster is properly used.
Otoscopy is an essential and routine procedure performed by audiologists that inherently places the provider’s face in close proximity to the patient’s face. With the ongoing emphasis of social distancing during the COVID-19 pandemic, invest in a video otoscope if for no other reason than to maximize the distance between you and you patient during otoscopy. The most popular video otoscope has been the Firefly Digital Video Otoscope, and easy-to-use and affordable product that made my list of “Favorite Things” way back in 2012.
Starting now and through the month of June 2020, Oaktree Products is offering FREE ground shipping in the US when purchasing any Firefly Digital Video Otoscopes (coupon code MAX). Three versions are available:
