Ever
since the program started up at Hilleroed Hospital in January, 2005, the Audiology department has been
screening high-risk and NICU infants as well as re-screening referrals from the PKU/hearing testing
performed by biomedical analysts in another part of the hospital.
By the end
of 2005, the new screening program could boast of having screened a total of 3448 babies representing
nearly 99% of those born in Frederiksborg county. Of the 3260 well babies screened, only 94 (2.8%) had
been referred for re-screening (so far 6 babies
with bilateral, and one with unilateral
hearing loss
have been identified).
Screening equipment needs to be easy to learn – and easy to use
Before audiology assistant Jeannette Frederiksen came to work in the Audiology department at Hilleroed, she had worked at the University Hospital of Copenhagen. There her first experiences performing OAE screening on babies were using a bulky home-made prototype. Unsurprisingly, Jeannette’s initial impression of the AccuScreen was favorable: ”It was so small that you can hold it in one hand – bear in mind that I was used to rolling a lot of equipment around the hospital. It was also easy to figure out and easy to use. There weren’t many questions as we tried it out on some older kids we were examining.”
The probe is a critical part of the equipment
Being the only component that comes into direct contact with the babies, the probe and eartips are critical to the speed and success of a screening. While the compact size and simplicity of the AccuScreen are appreciated, Jeannette is quick to praise the probe: “I think it’s good because, if it isn’t tight enough or if there’s vernix, it tells you there’s an error. Then you can take it out and check the ear again, or fit it tighter, and that usually solves the problem. The eartips are also really good at fitting in the ear canal – and staying there. There aren’t that many functions in the device itself, it’s nice and simple.”
And since the Audiology department doesn’t just screen “well” babies, the small size of the probe has proved crucial. According to Jeannette, there haven’t been any cases which could not be tested: “Some of the babies have a lot of vernix or very small ear canals, but then you just have to be patient and ensure a proper fit. In a few cases, we’ve had to hold the probe against the ear because the tip can’t sit by itself, for example, with premature infants. There have also been a few who’ve been too noisy or unsettled, so we’ve had to wait until they were sleeping.”
Fast OAE and AABR
A major factor for a department that has to perform both re-screening and screening of high-risk or prematurely born infants is that both OAE and AABR tests need to be done on each infant. Consequently, the dual-test capability of the AccuScreen is essential for efficient throughput.
Speed of measurement is another important factor in the efficient functioning of the screening program. In this regard, Jeannette comments: “Assuming that the ears are clear, first we screen with OAE, which is usually very quick. Of course, we always spend a little time talking to the parents, showing them what we’re going to do so that they feel comfortable. Then we start testing, and a few seconds later the display reads out ”pass” or ”refer”. Then we switch to AABR, which can take anything from a few seconds to 20 minutes – even if the baby is quiet.”
Baby screening is a rewarding task
Although dealing with the parents of a newborn baby found to have a hearing loss is difficult, the task of screening is rewarding: “I think it’s exciting to be a part of it and in my department, we’re glad to be involved because it’s here, after all, that they get fitted with hearing aids, if that’s what’s required. Of course, it’s not pleasant having to send them in to the consultant, but that’s part of the program. And it’s thrilling afterwards to see them with their hearing aid(s), and to follow them over time, and know that they’re developing better [than they would without intervention].”