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REFERENCE GUIDE
AABR, Natus, and Echo-Screen are registered trademarks of Natus Medical Incorporated.
NuPrep is a trademark of D.O. Weaver & Co.
Windows is a registered trademark of Microsoft Corporation.
Manufactured by:
Natus Europe GmbH
Bärmannstrasse 38
D-81245 Munich, Germany
www.natus.com
CONFIDENTIAL
PROPERTY OF NATUS MEDICAL INCORPORATED
ALL RIGHTS RESERVED
Table of Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Intended Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Safety Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Explanation of Terminology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Precautionary Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Documentation Conventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Example Data and Screen Shots . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Buttons, Menus, and Fields . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Screening Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Screening Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Step 1: Power on the Echo-Screen device . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Step 2: Enter Patient Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Step 3: Prepare Patient and Attach Supplies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Skin Prepping Techniques . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Applying Echo Couplers (Y probe cable) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Step 4: Start Screening/Monitor Progress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
TEOAE Screening Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
DPOAE Screening Procedure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Screening Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Viewing Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Understanding PASS & REFER. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
TEOAE results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
DPOAE Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
AABR Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Printing Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Quick Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Equipment Checks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Performing Self tests/Equipment Checks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Probe Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Discharge Battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Codec Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
LCD Display Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Keypad Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Memory Used . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Software and Hardware Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Echo-Screen Maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Cleaning the Echo-Screen Device . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Maintenance of the Probe Tip . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Cleaning, Disinfection, & Sterilization of the Probe Tips . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Probe Tip Cleaning Procedure:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Wet Cleaning and Sterilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Changing the Acoustic Filter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Cleaning, Disinfection and Sterilization of Ear Tips and Cleaning Wire . . . . . . . . . . . . . . . . . . . . 70
Warranty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Echo-Screen® Hearing Screener Limited Product Warranty . . . . . . . . . . . . . . . . . . . . . . . . 73
Technical Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Operating Conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Technical Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
TEOAE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
DPOAE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
AABR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Probe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Y Probe Cable. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Charger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Device Class . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Applied Standards. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Manufactured by . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
List of Illustrations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Safety Information
Explanation of
Terminology This manual presents three types of precautionary information. The three types
of statements carry equal weight; that is, they are of equal importance to the
safe and effective use of the device. Each statement is categorized by using an
introductory word in boldface as follows:
Precautionary
Information The following precautionary information pertains to the use of the Echo-Screen
Hearing Screener.
WARNING: Do not attempt to plug the ear probe, ABR, or Y probe cable
into any other equipment, as unspecified damage to either component may
occur. The ear probe, ABR, and Y probe cables are patient connected cables
and must only be plugged into the Echo-Screen device.
CAUTION: Never use any type of sharp instrument on the plastic keypad.
Reliable operation of Echo-Screen device can no longer be guaranteed if sharp
instruments are used.
CAUTION: Use only the Natus approved battery charger (REF 900729)
delivered with the Echo-Screen device. Battery chargers not approved by
Natus may not meet electrical and safety standards. Use of other chargers may
cause damage to the device and Natus is not liable for damages caused in their
use.
Documentation Conventions
some cases, these screen shots appear to contain patient data. This data is
fictional, having been created for illustration purposes only.
Screen Shots
The screens shown in the following pages may look different than the screens
on your particular system. Not all command buttons or on-screen choices may
be available, as software configuration allows for some features to be
assignable to custom profiles and the administrator of your system may have
configured your system differently than depicted.
Buttons,
Menus, and Fields In this document, the names of toolbar icons, buttons, and menu options are
displayed in teal. These items are selections you can make to execute the
described functions.
Field names, checkboxes, and radio buttons are displayed in bold. These
items represent places where you can enter data or choose an option.
Types of OAEs
Transient Evoked
Otoacoustic
Emissions TEOAEs are elicited by brief stimuli such as clicks or tone bursts. They can be
(TEOAEs) recorded in nearly all persons with normal hearing. TEOAEs are highly
non-linear. Their pattern of growth is consistent with the operation of the
cochlear amplifier, which provides most gain for the low level inputs, and lends
support to the notion that OAEs arise from outer hair cell activity.
TEOAEs do not correlate with behavioral audiometric thresholds. Thus it is not
possible to predict hearing thresholds based upon TEOAE thresholds.
However, since the presence of TEOAEs correlates strongly with normal
hearing, the most common clinical application involves click stimulation at
moderate intensity levels for the purpose of hearing screening or differential
diagnosis.
The Echo-Screen system uses a binomial statistical test to give either a PASS
or REFER result. In contrast to the signal averaging technique with two buffers,
typically applied in most TEOAE instruments, the Echo-Screen device
Distortion Product
Otoacoustic
Emissions DPOAEs are tones produced by the ear in response to two simultaneous
(DPOAEs) pure-tone stimuli denoted as primary tones. These emissions are distortion
products (DPs) in that they are not present in the pure-tone stimuli that elicits
them. The lower frequency pure-tone stimulus is represented by f1 and the
higher frequency pure-tone stimulus is represented by f2. The most frequently
measured DPOAE is at the 2f1 - f2 frequency, although the cochlea also
produces DPOAEs at other frequencies. This measurement is typically the only
one used for clinical applications.
The crucial task of the DPOAE evaluation is to discriminate the sound of the
environment — the noise — from the cochlear sound response — the DP.
Although the distinction can never be absolutely certain, a properly designed
statistical algorithm can reduce the probability of incorrectly classifying noise as
a cochlear signal to a known probability. With the Echo-Screen device, this
probability is 0.3% for each frequency applied. Conventional criteria commonly
used in this type of device show a false pass rate that is considerably higher (up
to 10% with the frequently used 6dB SNR criterion).
The Echo-Screen device utilizes a statistical solution that makes it possible to
evaluate the spectrum specifically at the frequency of the expected DP. Thus,
no comparison with adjacent spectral lines is necessary.
During a specific time, the acoustic activity at the expected DP frequency fDP =
2f1 - f2 is analyzed by reducing the spectral component to a unit vector. Its
phase is determined mathematically. By repeating this procedure, a set of unit
vectors with different phases is obtained. These vectors can be added using the
laws of vector addition in the polar coordinate system.
Recording OAEs Recording OAEs requires a sensitive, low-noise microphone to be sealed in the
external ear canal. Recording of OAEs elicited by an acoustic stimulus also
requires that two transducers deliver the stimuli. The microphone records the
sound present in the external ear canal. The type of signal analysis applied
depends on the type of emissions to be recorded.
OAE Applications TEOAEs are well suited and widely accepted for the purpose of hearing
screening. The presence of TEOAEs is a strong indicator that a portion of the
audiogram has hearing threshold levels better than 25 db HL, and correlates
best with good hearing in the mid-frequency range. It is not possible to rely on
the TEOAE spectrum to predict threshold levels by frequency.
Although DPOAEs do not allow clinicians to predict behavioral thresholds,
there is a correspondence between DP-gram configurations and audiograms.
That is, in ears having sensory hearing loss, DPOAEs are reduced or
eliminated only for the f2 stimulus frequency region that coincides with the
impaired region. Therefore, DPOAEs can give a better frequency-specific
impression of cochlear integrity than TEOAEs, and they are well suited to
monitoring cochlear function.
Although OAEs have not proven to be good predictors of auditory nerve tumors,
they can provide an opportunity to document normal or near-normal cochlear
function, which makes them helpful for locating site lesion and for making
management decisions.
Front View
Graphic LC
Display
LED Indicator
OK Button
Soft Keys
Navigation Arrows
Alphanumeric
Keypad
Keys, Terms,
Functions Table 1.Button functions
OK N/A •
•
Switches on the device
Activates the selected item
OK Button • Starts screening functions
OFF
BACK
•
•
Switches off the device from the main menu
Reverts to the previous menu/display
Soft key right SELECT
• Cursor for selecting Date/Time
STOP
• Discontinues screening
N/A •
•
Cursor for navigating the menus / scrolling up
Steps up the value of the setting in the
"Date/Time" menu
Navigation
arrow up
N/A • Cursor for navigating the menus /scrolling
down
• Steps down the value of the setting in the
Navigation
"Date/Time" menu
arrow down
MENU
OPT (Option)
•
•
Reverts to the main menu
Shows artifact and stimulus stability rate
Soft key left (TEOAE)
SKIP
PAUSE • Skips test functions (DPOAE)
• Interrupts screening (AABR)
Navigation Press the navigation arrows (up or down) to scroll through the menu items.
Selected items are highlighted black.
Press OK to activate menu functions highlighted by the black bar and to confirm
selections.
The current function of the soft keys is displayed in the bottom line of the
display.
CAUTION: Never use any type of sharp instrument on the plastic keypad.
Reliable operation of Echo-Screen device can no longer be guaranteed if sharp
instruments are used.
Data Entry Use the alphanumeric keypad to enter numbers and letters. Use the arrow keys
on the keypad (< and >) to move backwards and forwards.
The ear probe cable is designed for conducting TEOAE, DPOAE, and AABR
tests. Different sized ear tips are attached to the probe tip and then inserted into
the patient’s ear canal for testing.
Probe body
Test cavity The test cavity is used to test the functionality of the ear probe cable. The probe
tip of the ear probe cable is inserted into the test cavity.
Y Probe Cable
The Y probe cable is designed for conducting AABR tests. The colored
adapters of the cable generate clicks, which are delivered to the patient’s ears
through Echo Couplers. The Y probe cable is designed specifically for use with
Echo Couplers.
Connector to
Echo-Screen
ABR Cable
The ABR cable is designed for AABR tests. The cable consists of colored clips
which attach to Natus disposable snap electrodes. The cable transmits the
patient’s responses back to the Echo-Screen device.
Screening Supplies
Skin prepping materials, such as NuPrep® gel, remove surface oil or skin
debris at the sensor sites on the patient. These products lower the electrical
impedance of the skin and can improve the sensor connections. Your service
representative can provide information and options for supplies and prepping
materials.
Ear Tips The colored ear tips attach onto the probe tip end of the ear probe cable and
are inserted into the patient’s ear canal for TEOAE, DPOAE, or AABR tests.
The ear tips are available in different sizes to accommodate testing with
newborns, children, and adults.
This section provides instructions for the initial setup of the Echo-Screen device
prior to screening.
IMPORTANT: Ensure that the Echo-Screen device has all the appropriate
settings for your facility’s protocol prior to screening patients.
Unpacking the
Echo-Screen device Unpack the Echo-Screen system carefully. Inspect the equipment for possible
visual damage and ensure you have received all parts and accessories.
If damage has occurred, do not attempt to operate the device. Instead, contact
Natus Technical Service or your authorized service representative.
Storing the
Echo-Screen Device The Echo-Screen device is shipped in a protective carrying case. When not in
use, the device should remain in its carrying case to prevent damage.
The Echo-Screen device should be stored between the temperatures of 0-40ºC
(32-104ºF).
CAUTION: Use only the Natus approved battery charger (REF 900729)
delivered with the Echo-Screen device. Battery chargers not approved by
Natus may not meet electrical and safety standards. Use of other chargers may
cause damage to the device and Natus is not liable for damages caused by
their use.
Removing the
Battery Pack and
Connecting the Figure 11—Releasing the Battery Pack
Charger 1. Place the Echo-Screen device on a
flat surface with the back side facing
upward.
2. Use the index finger of the other
hand to press the button of the
battery until it clicks. Slide the battery
downward to remove it from the
housing.
Monitoring the
Battery Charge
The Echo-Screen battery charger controls the charge process automatically.
Process
The LED on the bottom of the charger indicates when the battery is charging
and when it is fully charged. The LED will also indicate any faults evident in the
system (see Battery charging LED messages on page 19).
LED flashing every * Trickle Charge: The battery pack is fully charged.
1.3 seconds
I-- -- -- -- -- -- -- I
Battery Test Press the OK button to turn on the Echo-Screen device. The device
automatically runs a battery test.
If the necessary minimum voltage should drop, the change battery message
appears on the display and the Echo-Screen device switches off automatically.
If this occurs, exchange the NiMH-battery pack and recharge it as soon as
possible.
Battery Safety
Information CAUTION: The charger is for indoor use only and should be protected
against moisture.
CAUTION: Keep the battery away from fire, as it can explode. Incorrect
handling, applying excessive charging current or reversing the poles, can
overcharge or destroy the battery.
CAUTION: Do not place the battery pack in contact with metal objects.
Increasing Service
Life • Use only the recommended battery charger unit.
• Charge the battery pack at room temperature whenever possible.
• Do not drop the battery pack or expose it to sharp impact.
• Store in a cool, dry place.
• Keep the battery pack terminals clean. (Clean with a soft cloth if neces-
sary)
Battery
Replacement &
Disposal To obtain a replacement battery pack, contact Natus Technical Service or your
authorized service representative. Follow your institution’s protocol for the
proper disposal of the battery pack.
Language,
Date/Time, Testing
Alert & Background
Light Settings Basic settings on the Echo-Screen device such as language, date/time, and
testing alert sounds can be selected and changed.
Background
Lighting (display) 1. Select Backlight from the Settings 1
menu and press OK to continue.
2. Select On or Off for the background
lighting and press OK to confirm.
If you select On, the background lights
up. If no keys are pressed, the light
automatically turns off after 20
seconds, and turns back on when a
key is pressed.
Jingle and key click Hear a click when a button is pressed and a jingle
when the Echo-Screen device displays a PASS or
REFER result.
Default Test Mode You can designate the default test mode (TEOAE, DPOAE, or AABR) that is
used for measurements.
1. Select Default Measurement from
the Settings 1 menu.
2. Select TEOAE, DPOAE, or ABR as
the default mode.
3. Press OK to confirm and return to the
Settings 1menu.
Edit Mode You can use Edit mode to define the default data input method for the
Echo-Screen device.
1. Select the appropriate edit mode:
• Select Hold mode to hold a key
down until the character appears on
the Echo-Screen display.
• Select Tap mode to tap a key
several times until the character
appears on the Echo-Screen display.
2. Press OK to confirm your selection
and return to the Settings 2 menu.
Note: You must press OK to confirm a new edit mode setting. Pressing
(MENU) returns to the main menu without storing the new setting.
Pressing (BACK) returns the Settings 2 menu without storing the new
setting.
User Mode User mode designates whether the Echo-screen device is to be operated by a
single user or by multiple users.
1. Select the appropriate user mode
setting:
• Select Single (no login) if you do
not need to specify the user name or
ID. This option disables the login
function.
• Select Multi (login) if multiple users
operate the Echo-Screen device.
This option enables the login
function. When the Echo-Screen
device is powered on, a user name
or corresponding ID must be selected
in order to proceed.
2. Press OK to confirm the selection
and return to the Settings 2 menu.
Note: You must press OK to confirm a new user mode setting. Pressing
(MENU) returns to the main menu without storing the new setting.
Pressing (BACK) returns to the Settings 2 menu without storing the
new setting.
Note: If the Multi (login) mode is enabled, the user ID (maximum of five
characters) in included on the Echo-Screen result label printouts. The user
name (maximum of 21 characters) is not included on the label printout.
1. Connect the Echo-Screen device for either wireless (infrared) or cable data
transfer. (See Transfer & Deletion of Patient Data on page 53 for details
about wireless and cable data transfer.)
2. Open the EchoLinkII software on the computer and then open Settings
from the main EchoLinkII menu.
3. Select User Login List from the Settings menu. A User Login List
appears.
4. Enter the appropriate User IDs (maximum 5 characters) and User Names
(maximum 21 characters) into the User Login List.
5. Click Upload to transfer the user names and IDs to the Echo-Screen
device.
Note: You must restart the Echo-Screen device after the upload is
complete.
Note: If any changes to the user names or IDs are required, they must be
made by using EcholinkII software and then uploaded again to the
Echo-Screen device.
Note: The Echo-Screen device prints only the User ID on the results label
printout. The User Name does not appear on the results label printout.
Patient List Mode Patient List Mode designates how the Echo-Screen device lists patient
information on the Patient List display.
1. Select the appropriate list mode:
• Select List by last names to list
patients by their last name in the
order in which they were entered into
the Echo-Screen system.
• Select List by ID numbers to list
patients by their ID number in the
order in which they were entered into
the Echo-Screen system.
2. Press OK to confirm your selection
and return to the Settings 2 menu.
Note: You must press OK to confirm a new patient list setting. Pressing
(MENU) returns to the main menu without storing the new setting.
Pressing (BACK) returns to the Settings 2 menu without storing the
new setting.
ABR Configuration
Setting You can use the ABR configuration option to set the appropriate voltage
frequency and stimulus level for AABR testing.
1. Select ABR configuration from the
Options menu and press OK to
continue.
Note: Check the regional mains voltage frequency before changing the
setting on the Echo-Screen device.
Note: You must press OK to confirm a new notch filter setting. Pressing
(MENU) returns to the main menu without storing the new setting.
Pressing (BACK) returns to the ABR Configuration menu without
storing the new setting.
Note: The 55 dB nHL stimulus level can only be used for AABR tests that
are conducted with the ear probe cable. The Y Probe cable cannot be used
for AABR tests conducted at the 55 dB nHL stimulus level.
Storing Default
Comments Comments regarding the patient’s state, test environment, and so forth can be
entered or selected for each screen and stored with the results.
You can enter a maximum of 25 default comments into the EchoLinkII software
by using a personal computer (PC) and then transfer them to the Echo-Screen
device prior to testing. At the time of the test, you can select one of the default
comments.
To set up default screening comments for the Echo-Screen device:
1. Connect the Echo-Screen device for either wireless (infrared) or cable data
transfer (See Transfer & Deletion of Patient Data on page 53 for detailed
instructions on wireless and cable data transfer).
2. Open EchoLinkII software from the PC and access Settings from the main
EchoLinkII menu.
The ear probe cable is required for TEOAE and DPOAE tests.
Plug the connector of the ear probe cable into Ear Probe socket (A) located at
the top of the Echo-Screen device (see Figure 14).
When connecting the cable to the housing, the red dot on the cable connector
must be aligned with the red dot above the socket of the Echo-Screen device.
Alignment dot
B A
Note: Use the Test Cavity to conduct a probe test prior to testing. One
probe test per day is recommended. (See Equipment Checks on page 61
for instructions on conducting a probe test).
When disconnecting the cable, grasp the sleeve of the connector and pull it out
to release it from the socket. Do not pull the connector by the cable.
AABR Tests
Note: Echo Couplers are intended only for use with newborn patients.
When disconnecting either the ear probe or the Y probe cable, grasp the sleeve
of the connector and pull it out to release it from the socket. Do not pull the
connector by the cable.
IMPORTANT: Prior to running a test, ensure that the Echo-Screen device has
all of the appropriate settings. See Setting Up the Device on page 17 for
detailed instructions on setting up the Echo-Screen device.
Note: Before the first screen of the day, conduct a probe test to check the
functionality of the ear probe and Y probe cables. (For additional
information see Probe Test on page 61 in the “Equipment Checks”
chapter).
Step 3: Prepare
Patient and Attach
Supplies TEOAE and DPOAE Tests
The ear probe cable is required for TEOAE and DPOAE testing. Ensure that
the ear probe cable is properly connected to the Echo-Screen device.
1. Check the patient´s ear canal and select an ear tip that fits. You may have
to try out different sizes to find an ear tip that provides the most secure fit.
Recommended ear tip sizes for patients:
• Newborns: 4 mm - 5.5 mm, Mushroom, and Tree
• Children: 6 mm - 10 mm
• Adults: 9 mm - 12 mm, 13.7 mm, and 17.8 mm
WARNING: The probe tip must not be placed into the ear canal at any time
without using a proper ear tip.
2. Push the ear tip onto the probe tip until it sits against the probe. Large ear
tips should be oriented so that their raised side faces the probe. Smaller
ear tips should be oriented so that their enlarged side faces the probe (see
figures below):
Large
ear tip
Small
ear tip
IMPORTANT: When attaching and removing the ear tip, hold onto the
housing of the probe and not the ear probe cable itself.
IMPORTANT: Ensure the probe has a snug fit. Any leakage may lead to a
prolonged test time due to distortion and excessive noise.
Note: It is acceptable to use the same ear tip for both ears. If there is
suspicion of infection in the external auditory canal, the ear tip should be
exchanged before testing continues on the other ear.
Note: In the event of a probe error, ensure that the probe tip channels are
free and the probe is connected. See Probe Test on page 61 in the
“Equipment Checks” chapter and Maintenance of the Probe Tip on page 67
in the “Maintenance” chapter.
AABR Tests
Electrodes must be attached to the patient’s skin for AABR tests. In addition,
you can either insert the ear probe (as described for TEOAE & DPOAE testing)
or place Echo Couplers over the patient’s ear when conducting AABR tests.
2. With the colored clips attached, apply the electrodes for the AABR test to
the patient as follows:
• Sensor with white clip: vertex (high forehead)
• Sensor with black clip: common (cheek)
• Sensor with red clip: nape (centered, back of neck)
Skin Prepping
Techniques Skin prepping reduces electrical impedance across the patient’s skin, which
allows for better conductivity of the small electrical signals that constitute the
ABR. Conductivity is enhanced by moisture, for example skin fluid or saline
solution. Conductivity is impeded by dry skin or oil on the skin.
In general it is not necessary to prepare the patient’s skin when conducting a
test with the Echo-Screen device; however, patients with oily skin or body hair
at the sensor sites typically exhibit higher impedance and may require prepping
in order to be successfully screened.
• Oily skin responds well to cleaning with mild soap and water followed
by prepping with NuPrep® gel (gel for neonates).
• Dry skin responds well to prepping with saline or NuPrep® gel, or a
drop of saline under each sensor.
Prepping Tips
• Prep the skin by creating some friction, but never using force. Be sure
you are moving the prepping pad over the skin, and not just moving the
skin under your fingers.
• Always prep an area slightly larger than the sensor site.
• Place infants on their side and tilt the head gently forward for easier
access to the nape sensor site. Separate the folds of the skin with one
hand and prep with the other.
• A drop of saline can help rehydrate slightly dry sensors, and may add
enough moisture to adequately decrease a marginal impedance
reading.
• If impedance readings are high, ensure that the sensors are attached
to the patient and cable clips are attached to the sensors. Also check
Note: Alcohol can be effective for babies with very oily or sebaceous skin,
but it dries the skin as well. If alcohol use is permitted, you may need to
follow with a wet gauze wash and/or prep with NuPrep gel to rehydrate the
skin.
Applying Echo
Couplers (Y probe
Ensure that the Y probe cable is properly connected to the Echo-Screen device.
cable)
IMPORTANT: The Echo Coupler is disposable and designed for
single-patient use. Do not reuse.
Note: Echo Couplers are designed for use only with newborn patients.
Note: Echo Couplers are intended only for use with the Y probe cable.
Do not attempt to use Echo Couplers with the ear probe cable.
Y Probe Cable
Echo Coupler Adapter
WARNING: Do not insert the red and blue Echo Coupler adapters directly
into the patient’s ear canal. The adapters must be inserted into the Echo
Couplers prior to testing.
2. Remove the Echo Couplers from their adhesive liner and place over the
baby’s ears as follows:
• Echo Coupler with red adapter: Right ear
• Echo Coupler with blue adapter: Left ear
Step 4: Start
Screening/Monitor
Progress Select the appropriate test mode
(TEOAE, DPOAE, or ABR) from the
Measure display and press OK to
continue.
TEOAE Screening
Procedure 1. Select TEOAE from the Measure
display and press OK to continue.
Additional information such as patient
state, or testing environment can be
entered for a TEOAE test.
3. Press OK to continue.
DPOAE Screening
Procedure 1. Select DPOAE from the Measure
menu and press OK to continue.
Additional information such as patient
state, or testing environment can be
entered for a DPOAE test.
3. Press OK to continue.
2000 Hz 4000 Hz
2500 Hz 3200 Hz
If necessary, you can press (SKIP) to skip the current frequency. The test
will proceed to the next frequency pair.
To cancel the entire test, press (STOP).
AABR Screening
Procedure IMPORTANT: Prior to AABR screening, verify that the ABR notch filter
frequency (50 Hz or 60 Hz) and stimulus level (35, 45, or 55 dB nHL) are set
according to your facility’s screening protocol. See ABR Configuration Setting
on page 26 of the “Setting Up the Device” chapter for detailed instructions on
setting the ABR configurations.
1. Verify that either the ear probe cable or Y probe cable is connected to the
ear probe socket of the Echo-Screen device.
2. Verify that the ABR cable is connected to the ABR electrodes socket of the
Echo-Screen device.
5. Ensure that the Echo Couplers are placed correctly over the baby’s ears
and that sensors are attached to the appropriate sites.
Monitoring the
AABR test progress An Impedance test is automatically
performed prior to testing:
• White indicates skin impedance of
the vertex electrode (high forehead).
• Red indicates skin impedance of the
nape electrode (back of neck).
White and Red impedance values
must be below 12,000 Ohms for the
test to proceed. (Optimum value is
less than 4,000 Ohms).
• Balance indicates the difference of the skin impedances of the vertex
and nape electrodes. This value must be below 4,000 Ohms for the test
to proceed (Optimum value is less than 2,000 Ohms).
If impedance values are high, try the following:
• Consider waiting a few minutes to see if the electrodes can build up an
optimal connection with the skin.
• Prep the electrode sites and ensure that the electrodes have been
attached correctly.
• Check whether the ABR cable is properly connected to the
Echo-Screen device.
• Try using a new set of electrodes to lower impedance.
The lower EEG value allows an easier test. If the EEG signal is too high (due
electrical noise or muscular artifacts) the indicator light on the front panel
display will flash red. The data measured during this time will be ignored.
The time bar and the EEG are directly correlated. Therefore, if the EEG is high,
the time bar will proceed slower.
Status messages
during AABR test: During the AABR screening, information about the current test conditions may
be displayed:
• Stimulus high or low indicates that the test stimulus has changed
during the measurement.If stimulus high is displayed, restart the test,
and if stimulus low is displayed, adjust the probe.
• A Bad conditions message is followed by a test abort. This indicates
that the test conditions are too poor for a successful measurement.
Either the patient is too restless or the electrode impedance changed
to unacceptable values. Retest the patient under better conditions or
change the electrodes.
• Interference indicates electrical interference due to electro-magnetic
fields (i.e. pumps, PC etc.). Try to move away from the source of
interference prior to conducting a test.
Example:
TEOAE result: REFER
Example:
AABR result: PASS
Unlike TEOAEs, the result displayed for DPOAEs is specified for each
frequency tested.
Like TEOAEs the most common causes for non-detection of DPOAEs include:
• Excessive cerumen or vernix is in the patient’s outer ear canal or is
blocking the ear probe. To avoid this, always check that the probe tip
and ear canal are free of such debris. Clean the probe tip and replace
the acoustic filter when necessary.
• Excessive environmental noise or poor probe fit within the patient’s ear
canal. In DPOAEs, this is especially true for the lowest frequencies.
Therefore, if the two low frequency bands REFER and the two high
frequency bands PASS, it is likely due to a non-optimal screening
environment.
For the instances listed above, re-testing is recommended after improving the
test conditions.
It must be mentioned that retro-cochlear hearing losses cannot be detected
with a DPOAE test.
Results from the Echo-Screen device can be printed onto a label printer via
wireless (infrared).
WARNING: Remove the probe from the patient’s ear and detach the
electrodes before printing results.
To print results:
1. Power on the Echo-Screen device.
2. Select Print Results from the main
menu and press OK to continue.
5. Turn on the printer and confirm that sufficient labels are loaded. Also
ensure that the printer’s infrared (IR) dongle is positioned approximately 6
inches (15 cm) from the IR window located at the top side of the
Echo-Screen device.
All Results Print all the stored test results for the selected patient. Press
OK to print all the results for the selected patient
Single Result List all the stored test results for the selected patient. Scroll to
select a single test result to be printed and press OK to print
it.
TEOAE Results Print all the stored TEOAE test results for the selected patient.
Press OK to print all the TEOAE results for the selected
patient.
DPOAE Results Print all the stored DPOAE test results for the selected
patient. Press OK to print all the DPOAE results for the
selected patient.
ABR Results Print all the stored AABR test results for the selected patient.
Press OK to print all the AABR results for the selected patient.
Example of a printout:
TEOAE, REFER result
Note: Any comments stored for a particular patient appear on the label
printout. The comments are automatically printed on a separate label.
Installing EchoLinkII
Software on the PC EchoLinkII software allows you to transfer Echo-Screen data to a personal
computer to conduct necessary data management functions.
2. Click on the link to download the EchoLinkII software onto your personal
computer. A series of messages guide you through the installation
process.
Transferring Test
Records from the
To transfer data to a PC using Infrared (wireless):
Echo-Screen Device
to a PC 1. Open the EchoLinkII program on the PC.
2. Select Settings from the main EchoLinkII menu, and then select Options
from the Settings menu.
Note: While the data transfer is in progress, the distance between the
Echo-Screen device and the infrared adapter should not exceed
31.5 inches (80 cm).
IMPORTANT: Ensure that objects do not obstruct the path between the
infrared adapter and Echo-Screen device while the data transfer is in progress.
2. Select Settings from the main EchoLinkII menu, and then select Options
from the Settings menu.
4. Select the appropriate baud rate. It is recommended that you try the higher
baud rate first. (The lower baud rate may be more suitable if you use a
laptop computer.)
5. Connect the data transfer cable to the Echo-Screen device. The connector
is located at the bottom of the Echo-Screen device. Connect the data
transfer cable to the appropriate PC COM port.
Transferring Test
Records from the PC
To transfer data to the Echo-Screen device using infrared (wireless):
to the Echo-Screen
Device 1. Open the EchoLinkII program on the PC.
2. Select Settings from the main EchoLinkII menu, and then select Options
from the Settings menu.
4. From the EchoLinkII Patient List, select the patient records that you want
to transfer to the Echo-Screen device. To select a patient, click in the
checkmark column corresponding to the patient(s) of choice.
IMPORTANT: Ensure that objects do not obstruct the path between the
infrared adapter and Echo-Screen device while the data transfer is in progress.
2. Select Settings from the main EchoLinkII menu, and then select Options
from the Settings menu.
4. Select the appropriate baud rate. It is recommended that you try the
highest baud rate first. (The lower baud rate may be more suitable if you
use a laptop computer.)
5. From the EchoLinkII Patient List display, select the patient records that
you want to transfer to the Echo-Screen device. To select a patient, click in
the checkmark column corresponding to the patient(s) of choice.
6. Connect the data transfer cable to the Echo-Screen device. The connector
is located at the bottom of the Echo-Screen device. Connect the data
transfer cable to the appropriate PC COM port.
Deleting Screening
Records IMPORTANT: The Delete data function deletes ALL records stored in the
Echo-Screen device at one time. Individual records cannot be deleted from the
Echo-Screen device. Ensure that the appropriate records are transferred to a
personal computer via EchoLinkII software prior to deletion.
Performing Self
tests/Equipment
Checks Select Self test from the Options
menu and press OK to continue.
IMPORTANT: One probe test per day is recommended for each cable prior to
screening patients.
Note: The probe tip of the ear probe cable must be inserted into the test
cavity before conducting a probe test. The Y probe cable does not need to
be inserted into the test cavity.
Memory Used The Memory used option provides information about the Echo-Screen
capacity for patient list memory and test result memory.
1. Select Memory used from the
Options menu and press OK to
continue.
Software and
Hardware
Information The SW/HW information option provides information about the Echo-Screen
system hardware, as well as the software installed on the device.
Probe Error! • Cable not connected • Ensure the ear probe cable is
• Probe tip occluded connected properly to the
Echo-Screen device.
• Check probe tip and acoustic filter.
Clean and/or replace as necessary.
• Check the probe housing for damage.
Testing not possible! Impedance of elec- • Check electrodes and replace them if
trodes or balance is too necessary.
high. • Repeat test if patient is in a quiet
state.
Change battery Battery empty < 5.5 Volt Replace the battery before continuing the
test.
Clock bat low Clock battery dis- Contact Natus Technical Service or your
charged authorized service provider (battery life-
time > 2 years).
LED flashes, numerical Internal error code • Note the error code.
code is displayed. • Contact Natus Technical Service or
your authorized service provider.
The Echo-Screen device can be cleaned with a damp cloth. If necessary, apply
a surface disinfectant.
CAUTION: Ensure that no moisture gets inside the probe or into the device
cable sockets.
Cleaning,
Disinfection, &
Sterilization of the
Probe Tips
WARNING: The probe tip must not be placed into the ear canal at any time
without using a proper ear tip.
probe tip
probe body
The probe tip does not usually come into contact with the skin or with secretions
from the ear canal since it is covered by an ear tip. However, if there is a large
amount of cerumen in the ear canal, the probe tip may become occluded with
debris. If this occurs, clean or change the probe tip prior to testing.
1. Remove the probe tip (B) by pressing the release button (A) while pushing
the probe tip carefully upwards out of the probe case.
2. Use the cleaning tool (C) to carefully remove the acoustic filter (D) from the
probe tip.
3. Use the cleaning tool (C) to clean the sound channels of the probe tip from
the rear.
CAUTION: Ensure that the sound channels are completely dry before
replacing the tip onto the body of the probe. Even the smallest amount of
moisture may dissolve any residual cerumen and thus contaminate the
sensitive acoustic filter in the body of the probe.
For disinfection:
• Use a chemical disinfectant of ethanol (70-80%), propanol (70-80%) or
aldehydes (2-4%).
CAUTION: Ensure that the sound channels are completely dry before
replacing the tip onto the body of the probe. Even the smallest amount of
moisture may dissolve any residual cerumen and thus contaminate the
sensitive acoustic filter in the body of the probe.
For sterilization:
• Autoclave according to the recommended standards for rubber
materials (121°C/249°F, 45 minutes exposure time). Probe tips can be
exposed to a maximum temperature of 150°C/302°F for up to 45
minutes.
Changing the
Acoustic Filter If the calibration procedure fails and the message "Probe Error!" is displayed,
the acoustic filter of the probe may be damaged or obstructed. In such a case,
the acoustic filter needs to be changed.
IMPORTANT: Acoustic filters are disposable. Do not place used filters back
into the probe accessory box. Do not attempt to clean or disinfect the acoustic
filters.
1. Remove the probe tip (B) by pressing the release button (A) while pushing
the probe tip carefully upward out of the probe case.
2. Use the cleaning tool (C) to carefully remove the acoustic filter (D) from the
probe tip.
Cleaning,
Disinfection and
Sterilization of Ear The ear tips and cleaning wire can be used as disposables. However, if they are
Tips and Cleaning reused on multiple patients, they must be wet cleaned and disinfected between
Wire each use.
To clean the ear tips and cleaning wire, see Wet Cleaning and Sterilization on
page 69.
Note: Sterilization of ear tips is required if they are used with patients that
have infected ear canals. Sterilization of the cleaning tool is required if it is
used with a probe tip that has been exposed to an infected ear canal (see
Wet Cleaning and Sterilization on page 69).
Cleaning of the Y
Probe Cable The Y probe cable should be cleaned after each working day; however, if there
is any risk of transfection, the Y probe cable should be cleaned prior to
screening a new patient.
2. Clean the Y probe cable and Echo Coupler adapter with an alcoholic
disinfectant tissue.
Maintenance of the
Battery Refer to Setting Up the Device on page 17 for detailed information on
maintenance of the battery.
reserves the right to disclaim all responsibility for the operation safety, reliability, and
performance of equipment, serviced or repaired by other parties.
The annual technical control is defined in accordance with the corresponding
instructions for audiometers.
While your Echo-Screen is being calibrated, it is possible to borrow a “loaner”
device so that your test program can continue.
Shipping Procedures
If Natus reasonably determines that a repair or replacement is covered by the
warranty, Natus shall bear the costs of shipping the repaired or replacement
Product to the Purchaser. All other shipping costs shall be paid by the Purchaser.
Risk of loss or damage during shipments under this warranty shall be borne by the
party shipping the Product.
Products shipped by the Purchaser under this warranty shall be suitably packaged
to protect the Product. If Purchaser ships a product to Natus in unsuitable
packaging, any physical damage present in the Product upon receipt and
inspection by Natus (and not previously reported) will be presumed to have
occurred in transit and will be the responsibility of the Purchaser.
Exclusions
This warranty does not apply to the battery, or to expendable items, or to normal
wear.
This warranty applies only to instruments purchased from authorized distributors or
representatives.
This warranty does not extend to any Warranted Products (or parts thereof): (a) that
have been subject to misuse, neglect or accident, (b) that have been damaged by
causes external to the Warranted Product, including by but not limited to failure of
or faulty electrical power, (c) that have been used in violation of Natus’ instructions
for use, (d) that have been attached to any accessory that has not been subject to
Natus’ control over quality of materials and design, (e) on which the serial number
has been removed or made illegible, (f) that have been modified by anyone other
than Natus or its authorized service center, unless authorized prior to such service
by Natus. The Echo-Screen calibration is not covered under the standard warranty.
Natus makes no warranty (a) with respect to use of Echo-Screen Hearing
Screeners, any non-Natus disposable products, or any other products that are not
Warranted Products, (b) with respect to any products purchased from a person
other than Natus or a Natus-authorized distributor, or (c) with respect to any product
sold under a brand name other than Natus unless such product has been subject
to Natus’ control over the quality of materials and design.
This warranty, together with any other express written warranty that may be issued
by Natus, is the sole and exclusive warranty as to Natus’ products, extends only to
the purchaser and is expressly in lieu of any other oral or implied warranties
including without limitation any implied warranty of merchantability or fitness for a
particular purpose. Natus shall not be liable for any incidental, special or
consequential loss, damage or expense (including, without limitation, lost profits)
directly arising from the sale, inability to sell, use or loss of use of any product.
Operating
Conditions Storage temperature range: 0 - 40°C (32 - 104° F)
Operation temperature range: 5 - 35°C (40 - 95° F)
Humidity: 20-80% rel.
Transport altitude: 0 - 12,000 ft. (0 - 3.65 km)
Technical Data
General weight Echo-Screen incl. battery pack and probe: 1.2 lbs (550 g)
size Echo-Screen incl. battery pack: 230 x 95 x 53 mm
battery 6V 1500mAh NiMH, easily changeable. 2 batteries
supplied with device
charger charge time approx. 2 hrs.
power consumption 1.2 W max
power management auto backlight control, auto switch off,
2-level battery voltage sense, battery saver
operating time > 10 hrs with fully charged battery
CPU 16 bit fixed-point DSP, 22.1 MIPS
AD / DA converters 2 channels AD, 2 channels DA
resolution 16 bit
sampling rate variable
data memory 128 kByte built-in flash memory, unlimited storage
time
real time clock special battery, runs 2 years min.
interfaces RS232 up to 115 kbps, infrared, modem available
display 128 x 64 dot graphic LCD w/ switchable backlight
keyboard 17 keys
sound piezo beeper for key click and info / warning jingles
languages up to 6 user selectable languages available on the
device. language packs can be uploaded by service
personnel
probe ultra-lightweight probe
A D
AABR data entry 10
description 7–8 data entry mode 24
preparing for 34–36 data input 23
screening procedure 41 data transfer 53
test results 45, 49 date/time
test setup 29 format 21
uses 1 setting 21
AABR® 7 default test mode 23
ABR (auditory brainstem response) 7 deleting patient data 57
ABR cable 14, 29, 34 device
ABR configuration setting 26 cleaning 67
ABR Notch Filter setting 26 components 9
ABR stimulus level setting 27 memory 61
acoustic filter 69 power up 31
age, minimum 1 setting up 17
alcohol 36 settings 20
alphanumeric keypad 10 storing 17
automatically powers off 31 technology configurations 8
unpacking 17
B use 1
background lighting 22 user interface 10
battery discharge battery 62
charging 17–18 disinfecting probe tip 67
connecting charger 18 Distortion Product Otoacoustic Emissions technology.
discharge 62 See DPOAE technology
disposal 20 DPOAE
removing 18 compared to TEOAE 7
replacing 20 description 6–7
safety 19 preparing for 32–34
skipping test 31 screening procedure 39
test 19 test results 41, 48
buttons, functions 10 test setup 29
uses 1
C
cables E
ABR 14, 29, 34 ear probe cable 13, 29, 30
cleaning 70 ear tip 15, 32–34
data transfer 54, 56 attachment 33
ear probe 13, 29, 30 cleaning 70
testing 13 recommended size 33
Y probe 13, 30, 36, 43 Echo Couplers 15, 30, 34, 36, 43
charging battery 17–18 EchoLinkII software 53
check equipment 61 Echo-Screen
cleaning back view 12
device 67 bottom view 11
probe 68, 69 elements 9
probe tip 67 top view 11
cleaning wire 70 edit mode 24
Codec test 62 electrodes, snap 15, 34
comments 37, 40, 42, 43, 52 entering data 10
storing 27 equipment checks 61
configurations, technologies 8 error messages 65
connecting charge 18
Control Panel buttons 10 F
Couplers, Echo 15 filter, changing 69
compared to DPOAE 7
description 5–6
preparing for 32–34
screening procedure 37
test results 39, 48
test setup 29
uses 1
test
cavity 13
equipment 61
quick 59
starting 37
test mode 23
testing battery 19
skipping test 31
time setting 21
transferring patient data 53, 54, 55, 56
Transient Evoked Otoacoustic Emissions technology.
See TEOAE
troubleshooting 65
types of OAEs 5
U
unpacking device 17
use of device 1
user interface 10
user login information 25
user setting 24
V
voltage frequency setting 26
W
warranty 73
wire, cleaning 70
wireless 53
data transfer 53, 55
printing 51
Y
Y probe cable 13, 30, 36, 43
cleaning 70