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A SelectSmart.com Flowchart by Hayley. See Hayley's 4me blog page.
Viewed 111 times. Created July 2014.
This SelectSmart.com Medical flowchart, a free online decision tool is a creation of Hayley and for amusement purposes only. The implicit and explicit opinions expressed here are the author's. SelectSmart.com does not necessarily agree.
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By Hayley
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Child has been referred from Ear's Nose and Throat for a hearing assessment because previously she has had Otitis Media with Effusion Prior

               
Take relevant History from carer
Initally use sound field testing to condition the child to do test.
YES
Put headphones on to get ear specfic information and perform masking is applicable.
YES
Perform Otoscopy
YES
Perform Tympanometry

YES

YES


NO





YES
Perform play audiometry using man in the boat, ball on the stick and building blocks
 
If child will not condition change to Visual Reinforcement Audiometry in soundfield, using both towers and computer screen for videos
Discharge back to ENT
YES
Discuss the results with the carer. Is hearing within the normal range?





NO

YES



NO
 
 
Try to get bone conduction
Child performs VRA in sound field
Follow up in 3 months in Audiology if Child has conductive hearing loss. If child has a mixed or sensorineuralhearing loss hearing aids will be dicussed.





NO

YES



 
 
Perform Otoscopy
 
Discuss the implications of a hearing loss either conductive or sensorineuraland the difficulties a child may have in listening environments.





YES




 
 
perform tympanometry.
Discharge patient to ENT and send report
 





YES


YES


Discuss results with carer and review child in a few weeks back in Audiology
 
Is all testing achieved today that is possible?
Is hearing wihin normal range and OME has cleared?
NO
Follow up in 3 months in Audiology if Child has conductive hearing loss. If child has a mixed or sensorineuralhearing loss hearing aids will be dicussed.

YES



NO

YES

YES

YES


Unable to get results today
NO
Perform VRA with inserts to get ear specific information including masking if appropriate.
YES
Perform bone conduction if required with masking if appropriate
Discuss results with carer
Discuss the implications of a hearing loss either conductive or sensorineuraland the difficulties a child may have in listening environments