NRR stands for “Not Really Realistic”

Posted on March 8, 2011 by AU Bankaitis

In the United States, hearing protection devices such as earplugs and earmuffs require a Noise Reduction Rating (NRR) to be listed directly on product packaging. The NRR is a dB value reflecting the level of attenuation a hearing protection product provides as evaluated under laboratory conditions. The higher the NRR value, the greater the attenuation.

Since the NRR is a laboratory derived numerical estimate of attenuation, the actual amount of attenuation provided by a specific hearing protector in real-life work situations will most likely not correlate with the NRR.  As outlined by the American Academy of Audiology’s position statement on preventing noise-induced occupational hearing loss, various studies have documented that labeled NRR bears little resemblance to actual NRR achieved in practice. To better estimate actual attenuation values, the National Institute of Occupational Safety and Health (NIOSH) recommended several procedures with the following formula representing the most straightforward approach:

Estimated Actual Attenuation =  dBAw – (NRR-7)/2

In the above formula, dBAw represents measured occupational noise levels of a particular occupational work setting whereas the NRR is a value taken directly from product packaging.  Assuming that a work setting’s noise levels have been measured at 90 dBA and an employee is wearing earmuffs with an NRR of 29 dB, the values are entered into the formula as follows:

Estimated Actual Attenuation =  90 dBA – (29-7)/2

The next step is to automatically subtract 7 dB from the NRR value listed on product packaging.  In the above example, it is necessary to subtract 7 dB from 29 dB which equals 22 dB. This correction factor is a safety margin to account for spectral differences in C- versus A-weighted dosimeter measurements.  Next, that derived value of 22 dB must then reduced to half or divided by 2.  This 50% reduction is another safety margin designed to account for field versus lab differences in attenuation. So, in this particular work environment, when using hearing protection labeled 29 dB NRR, the estimated actual level of attenuation is 11 dB. For more information on noise conservation, check out the library of courses offered through AudiologyOnline including Clinical Evaluation of Hearing Protectors by Tom Thunder.

Posted in Hearing Conservation | Tagged , , , , , , , | 5 Comments

Telephones & Hearing Aid Compatibility

Posted on March 4, 2011 by AU Bankaitis

The Hearing Aid Compatibility (HAC) Act of 1988 requires all landline telephones manufactured or imported for use in the United States to be hearing aid compatible. In other words, all corded and cordless telephones that plug into a jack in the wall must provide inductive and acoustic connections that allow hearing instrument (and/or cochlear implant) users to communicate by phone.  At the time Congress passed the law, cell phones were exempt since Congress considered this technology non-essential. As such, many hearing instrument wearers experienced a loud buzzing noise when trying to use cell phones. In the past 5 years, the government has responded by partially lifting the exemption of cell phones from HAC, mandating compliance with ANSI C63.91. For more information on cell phone interference, see the previous post in this blog entitled No-Buzz Cell Phone Solutions.

When the HAC Act was mandated, all cordless phones were 900 MHz analog devices and, therefore, worked well with hearing instruments.  Since then, cordless telephone technology has evolved to digital products operating at the 2.4 GHz or 5.8 GHz frequencies. Unfortunately, this caused hearing instrument users to experience the same audible buzzing noise seen with cell phone use when trying to use a landline cordless telephone!

As a result of consumer feedback, the Telecommunications Industry Association (TIA) and cordless phone manufacturers formed a working group to address the issue and offer a solution. The outcome was the development of TIA-1083 , a performance benchmark  outlining digital cordless telephone performance measurement requirements designed to reduce interference hearing instrument users were prone to experiencing. Many corded phone manufacturers have indicated phased-in commitments to 100% compliance by 2010 although this is not necessarily a mandated requirement of all cordless phones. Cordless phones meeting the requirements of this standard will typically be labeled as TIA-1083 compliant on the packaging. So, if your hearing instrument patients are concerned about getting a cordless telephone that is hearing aid compliant, the best choice is to choose a phone that is TIA-1083 compliant.

Posted in Hearing Assistance Technology | Tagged , , , , , , , , | 5 Comments

Up-to-date info on Amplified Stethoscopes

Posted on March 1, 2011 by AU Bankaitis

Medical professionals rely on auscultation to routinely examine the status of the circulatory, respiratory, and/or gastrointestinal systems. Auscultation is defined as listening to internal sounds of the body and represents an essential component in the delivery of health care services.  The procedure is accomplished via a stethoscope, a medical device specifically designed to enable physicians, nurses, and other medical professionals to detect and analyze heart, lung, and/or bowel sounds. The art of auscultation not only requires a level of clinical skill, but also assumes the presence of optimal listening conditions that enable clinicians to hear what needs to be heard.

For medical professionals with hearing loss, routine use of traditional stethoscopes creates several challenges. The good news is there are viable solutions available, however, there isn’t a one-size-fits-all approach as various aesthetic and/or technological limitations may serve as barriers to the management process. The best approach to finding a viable solution is to rely on resources. The Association of Medical Professionals with Hearing Loss (AMPHL) provides information, promotes advocacy, and offers a support network of hearing healthcare professionals with hearing loss. Tomorrow, AudiologyOnline will offer a free-to-view live webinar entitled Amplified Stethoscope Options for Professionals with Hearing Loss presented by A.U. Bankaitis of Oaktree Products.  If you can’t make it, no worries! Browse AOL’s CEU-Total Access Library to view a recorded session.

Be sure to take advantage of other resources via the Ask The Expert series on AudiologyOnline. There is a nice summary provided by Dr. Samuel Atcherson addressing Options for Using a Stethoscope with Hearing Aids.   Linn Tearney of Cochlear Americas addresses Using a Stethoscope with a Cochlear Implant.  Check out the short posts addressing Bluetooth Amplified Stethoscopes and Stethoscope Solutions for Hearing Aid Wearers.  These short pieces of information may be a great addition to your resource library.

Posted in Amplified Stethoscopes | Tagged , , , , , , , , , , , | 2 Comments

Three is the Key for Mechanical Removal

Posted on February 24, 2011 by AU Bankaitis

Not sure what instruments to invest in for mechanical removal of cerumen? While the number of available hand-held instruments is endless, don’t spend your money on instruments that you don’t need or won’t use. Here are my quick tips on the three tools you essentially need.

First, invest in a tool that is most efficient for removing cerumen that is of a softer consistency such as a Buck or Shapleigh curette, a Billeau loop, or a right angle hook, specifically the Lucae hook. The tool that you choose will be a matter of personal preference. My favorite has always been the angled Buck curette.

Second, invest in a hand-held instrument specifically designed for removing cerumen that is of a much drier consistency. Probably the most popular instrument includes Alligator forceps although you can also try the Bayonette forceps. Personally, I prefer the NeoZoline Alligator forceps since these instruments have been coated in a special material that makes them black, eliminating any reflection that may occur during cerumen removal procedures when the ear canal is illuminated.

Finally, invest in the Day hook. This instrument is a right-angled hook with an extremely thin tip; since the tip of this instrument maintains such a small surface area, it is the perfect instrument to use for creating the initial hole in a complete occlusion. Using an instrument with a more substantial tip can potentially move the cerumen plug further in down the ear canal, creating additional challenges and more work.  Here’s to safe and effective cerumen removal!

Posted in Cerumen Management | Tagged , , | Comments Off on Three is the Key for Mechanical Removal

Amped-up Neckloops!

Posted on February 22, 2011 by AU Bankaitis

Did you know there are amplified neckloops available for your patients to use not only for hearing cell phone conversations via their t-coil equipped hearing instruments but to also talk back to the other party during the cell phone conversation?  For example, the ClearSounds CS-CLA7v2 is an amplified neckloop with a built-in microphone that is capable of picking up the user’s voice and directing it back to the cell phone. In addition, this amplified neckloop provides up to 30 dB of additional gain that may be adjusted via a rotary volume control wheel located on the side of the neckloop base. It comes packaged with five additional connection cables to allow for hands-free connection with a variety of other devices including home and office phones, laptop computers, portable gaming devices, MP3/iPods, personal/TV listening systems and other audio devices.  There is also a new cable available for connecting the iPhone to the CLA7v2 neckloop.

If your patient is interested in a Bluetooth option, the ClearSounds Quattro Bluetooth neckloop is available. It works just like the CLA7v2 with the exception that it does not require the use of connectivity cables. Once the Quattro is paired with another Bluetooth enabled device, information is transmitted wirelessly. In the event a particular audio source of interest is not Bluetooth enabled, an optional Bluetooth transmitter called the QLink is available. The QLink interfaces with the non-Bluetooth audio source and, in turn, transmits Bluetooth signals from the audio source directly to the Quattro. The other nice thing about this neckloop is that it comes equipped with a 3.5 mm stereo headphone jack, enabling non-hearing instrument wearers to use the device with headphones. It also supports A2DP technology for streaming audio and media. For more information on these and other amplified neckloop products, contact Oaktree Products at 800.347.1960.

Posted in Hearing Assistance Technology | Tagged , , , , , , , , , | 1 Comment

Getting to know you…

Posted on February 17, 2011 by AU Bankaitis

For those of you in the blogosphere following my Golden Nuggets of Information, this is a quick update of things to come. In the near future, my blog will feature polls that will enable followers and casual readers to actively provide feedback regarding what specific topics should be covered and what products you want to learn more about.  In addition, I will try to recruit colleagues to provide guest-posts about various aspects of audiology.

If you are not currently subscribed to my blog, make your life easier by signing up as this will automatically send bi-weekly posts directly to your e-mail. Simply enter your e-mail address in the top right-hand corner of my home page and hit the SIGN ME UP A.U. button.  You will receive an automated message from WordPress. Click on the hyperlink in the body of that e-mail to confirm your subscription. Keep in mind that these automated e-mails sometimes get funneled to your spam folder and you may need to look there to complete the process.

Access previous blogs via the horizontal menu at the top of the home page and/or the vertical menu bar located on the right-hand side of the home page. Each blog post offers readers the opportunity to comment in the comment section; I encourage all of you to share your wisdom, thoughts, and experiences as it relates to the posted topic.  Your comments will be published and accessible to all by either accessing each post individually or via the FEEDBACK FORUM section on the right-hand side of the home page. Everyone, including myself, will certainly benefit from this knowledge-share. Thanks for your continued support!

Posted in About A.U. | Tagged , , , | 2 Comments

EarPlanes for the Airplane

Posted on February 15, 2011 by AU Bankaitis

Many business and recreational air travelers experience some ear pain during take-off and landings; a convenient product designed to alleviate this type of air travel discomfort is readily available for you and your patients. EarPlanes is a patented pressure earplug developed by Cirrus Healthcare Products, LLC in conjunction with the House Ear Institute in Los Angeles, and tested by the US Navy aviators at the Miramar Naval Air Station in San Diego.

Comprised of a hypoallergenic silicone earplug and a ceramic pressure regulator, the earplug provides an airtight seal while the CeramX filter monitors cabin pressure differences, adjusting the differential flow through the earplug for maximum comfort. This product is packaged in pairs and available in both adult and children’s sizes. According to the manufacturer, each pair may be used for one round-trip journey or two flight segments.  With spring break and vacations right around the corner, consider stocking some in the clinic for resale to your traveling patients.

Posted in Tools & Accessories | Tagged , , , | 3 Comments

Roll-On Adhesive to Keep Hearing Aids in Place

Posted on February 10, 2011 by AU Bankaitis

Occasionally, BTE hearing instruments need a little help staying in place on the side of a patient’s head. Traditional methods of securing BTE hearing instruments firmly in place may involve the use of oval, double back adhesive pads or 3M double stick contour tape that is pre-cut into the shape of a BTE.  One alternative and interesting product available through Oaktree Products is an adhesive called IT STAYS. This product is a roll-on body adhesive that may be used to hold any article in place against the skin.  For use with BTE hearing instruments, simply roll the adhesive onto the skin behind the ear and press the body of the BTE in place. IT STAYS is pliable and moves with the body.  It washes off the skin easily with water without leaving any type of stain.  Any residue on the hearing instrument may be easily removed with a disinfectant towelette. The adhesive is available in a 2oz roll-on bottle for about $10. Keep in mind that the image shown above of IT STAYS may not be a true representation of the current look of the bottle that you may receive; the important point is that the packaged product is the same adhesive.

Posted in Tools & Accessories | Tagged , , , , , | 4 Comments