Painting the Hearing Conservation Picture
MAJ Eric Fallon
The author will discuss the need to better define the Army’s Hearing Conservation Program in garrison and the forward deployed setting. It is imperative that all army audiologists take part in restructuring this program to better meet the needs of todays deployed soldier in all settings. A prototype of an army hearing conservation program that fulfills the garrison and forward deployed mission will be presented for discussion.
Clinical Audiology Business Practices and Composite Healthcare Computer System, CHCS–II
LTC Kathy E Gates
Composite Health Care System (CHCS–II) is really coming! Army Audiology Clinics have been using CHCS–II to document Audiology clinical encounters for over a year. These audiology encounter templates were developed using the Audiology Clinical Practice Guidelines. I will demonstrate how to use audiology encounters templates in CHCS–II. Options to attach and include the audiogram report in the patient encounter will be discussed. Use of CHCS–II for clinical audiology will allow for an automated capture of Clinical Audiology services in the Corporate System giving Health Care providers electronic access to our clinical audiology data.
ASHA’s Joint Committee on Evidence-based Practice—A Year in Review and the Road Ahead
Thomas Helfer Ph.D.
Early in 2004 the American Speech-Language and Hearing Association’s (ASHA) Vice-president (VP) for Research and Technology and the VP for Professional Practices in Speech-Language Pathology (SLP) formed the Joint Coordinating Committee on Evidence-based Practice (EBP). Audiologists and Speech Language Pathologists selected and invited to serve on the committee represented clinicians, researchers, and teaching faculty in a variety of work settings. All committee members exhibited a career-history addressing an aspect of evidence-based practice. The committee was charged with assessing the issue of EBP in relation to examining the needs and planning development opportunities for ASHA’s 100,000 members. The committee communicated via telephone conference calls and email during early spring to early summer. The committee met face to face and deliberated at the ASHA national office for three days in July. From these meetings and follow-on the committee produced ASHA’s official position statement on EBP. They also wrote a reported that recommended a long term roadmap for guiding ASHA’s efforts to support EBP for Audiologists and SLP’S. This presentation summarizes the position statement and the committee’s report with respect to the impact on the practice of Military.
Prevalence of Noise-induced Hearing Loss in In Post-deployment Soldiers September 2002-April 2004
Thomas Helfer Ph.D., Nikki Jordan, Robyn Lee
Reportedly referrals to Audiology are the fourth highest cause for post-deployment medical referral. There are emerging data sets containing information on operational hearing loss from deployments. One is the Ambulatory Data Module (ADM). The Unified Bio-statistical Utility (UBU) working group has assigned Military Health System extensions to an ICD-9 code for designating pre-, during- and post- deployment clinic visits in ADM. An Audiology clinic “Superbill” contains the ICD-9 codes for hearing loss, and external causes of injury codes (E-codes) for noise exposure. Using data from the ADM database, this exploratory study evaluates post-deployment and non-deployment Audiology clinic visits for hearing loss due to noise exposure.
Hearing Protection Forward
Doug Ohlin, Ph.D.
Hearing protection is now available that also promotes communication and situational awareness. The combat arms earplug which was introduced in 2001 has achieved widespread acceptance among US soldiers and Marines. The Communication Enhancement Protection System has been in use among special operations personnel in Iraq and Afghanistan. A review of these types of devices will presented includes their applications, limitations and advantages.
Hearing Conservation in Increased OPTEMPO Environments
LTC Vickie L Tuten
Military Hearing Conservation has had to evolve in the face of large-scale deployments/redeployments and mobilizations/demobilizations. Army Audiology has had some recent mandates for deployment with the requirements for DD2215s and pre-formed hearing protective devices. These mandates are welcomed for their attention to hearing loss as it relates to soldier combat readiness. It has forced Hearing Conservation Program Managers to look at how effectively they are doing things in the Hearing Conservation arena. Can we meet the expectations for timely processing of soldiers at SRPs while not compromising quality of care? This presentation will focus on presenting the challenges and will further discuss some of the successes and failures in the program at Fort Hood during OEF/OIF in meeting those challenges. The intent of the presentation is to present ideas on how to do it right while doing it fast…and to spur further discussion of how we might do it better.
Review of Non-Auditory Effects of Noise
LTC Lorraine Babeu
MAJ Cheryl Cameron
The auditory effects of noise on the ear are well known in the audiology community; however, the non-auditory effects of noise have not received much attention. Noise like any other stressor activates the sympathetic division of the autonomic nervous system (ANS). Activation of the ANS increases heart rate and hormone production as part of the body’s effort to respond to the stressor. This response is commonly known as the “Fight or Flight” response. Prolonged activation of the sympathetic nervous system can cause the sympathetic nervous system to go into to a state of over arousal or under arousal causing negative health effects such as hypertension and heart disease. This presentation will review the autonomic nervous system (ANS), identify non-auditory effects of noise and finally discuss intervention strategies that can help reduce the stress associated with noise exposure.
Level-Dependent Hearing Protection and Sound Recognition in an Open Field
LTC Lorraine Babeu
Within in the last ten years there has been great interest by the US Army in level dependent earmuffs and earplugs such as the Combat Arms Earplug which was developed at the French-German Institute. Since the use of level dependent systems are relatively new to the military’s inventory of personal protective equipment, there has been little research done by the US Army to determine the effect of the systems on human performance. The purpose of the study is to determine the effect of level dependent hearing protection, when compared to traditional hearing protection, on the user’s ability to recognize sounds at various distances. Twenty-two subjects wore the following hearing protective devices. Two of the devices were the level dependent Combat Arms Earplug yellow side and the E-A-R 9000 noise muffs. The other two devices were non level dependent Combat Arms Earplug green side and E-A-R 3000 noise muffs. They were asked to identify sounds presented at 50-300 meters from their position in an open field.
Back to Basics: How to Evaluate the Dizzy Patient without Equipment
Holly Burrows, Ph.D.
Patients with symptoms of dizziness, vertigo and/or other balance problems when referred to an Audiology Service for evaluation can be tested using traditional VNG/ENG, rotary chair or posturography equipment. If an audiologist does not have access to this equipment in the clinic, there are tests that can be performed to assess a patient’s symptoms. In this session, we will discuss and demonstrate several “low-tech” procedures, such as dynamic visual acuity, tests of postural stability and other measures, which can help to differentiate among central disorders, peripheral vestibular disorders of unilateral or bilateral origin and non-vestibular disorders. These procedures are not designed to replace the quantitative results from laboratory studies obtained using equipment such as those listed above, rather they can be used, in conjunction with a comprehensive case history, to provide an initial impression of the potential pathology within the balance system, help to initiate necessary referrals as well as estimate the compensation status of the patient.