Do audiometry tests have to be conducted in an enclosed cabin? Are there systems to conduct the tests with head phones in a naturally ventilated space?
It is a good question. If the patient is wearing a face mask (NOT an N95 respirator) then it should be fine as long as the patient is not coughing and there is good ventilation. If there is external noise it is very difficult to do a proper assessment. Yes there are systems with head phones but they are quite expensive. Shaheen
Prof Shaheen Mehtar MBBS, FRC Path (UK), FCPath (Micro) (SA), MD (Lon) Chair of Infection Control Africa Network (ICAN) Head of Academic Unit for Infection Prevention and Control Tygerberg Hospital &Fac of Health Sciences, Stellenbosch Uni PO Box 19063, Tygerberg 7505, Cape Town Tel: +27 21 938 5051 Fax: + 27 21 938 5065 Mobile: +27 82 852 3697 http://www.sun.ac.za/uipc Visit the Infection Control Africa Network (ICAN) website on http://www.ICANetwork.co.za
As Shaheen indicates, the booth is needed for silence, even with headphones. Since only the patient is in the booth, there should be no TB transmission control risk. Since booths tend to be small, they can be easily ventilated between patients with a simple exhaust fan (but not during testing because of noise). Tariq, was there more to your question?
I have an additional question about TBIC for audiometry.
In our setting, the audiometry will be done in the office an ENT professional. These offices do not have booths but are supposedly a “quiet place”, quiet enough to perform audiometry. There is no option for this test to be performed in another location. The office is usually located in a large multidisciplinary, ambulatory facility. Understanably I have some concerns about this situation as the majority of TB patients who go there have received a diagnosis of TB but have not yet started threatment. So, from an IC point of view, this is what I plan to suggest, let me know what you think: 1. Patient with referral is triaged (no waiting in line) 2. Patient wears surgical mask. 3. Technician wears respirator 4. Clearance time of 15minutes using natural ventilation after patient leave before regular ENT clinic is resumes. (I know that 15 minutes clearance time is not much, but I doubt the staff will wait at all before bringing other people into the room no matter what education or policy is in place, that’s just how it is in our context, so I tried to pick ...
I have an additional question about TBIC for audiometry.
In our setting, the audiometry will be done in the office an ENT professional. These offices do not have booths but are supposedly a “quiet place”, quiet enough to perform audiometry. There is no option for this test to be performed in another location. The office is usually located in a large multidisciplinary, ambulatory facility. Understanably I have some concerns about this situation as the majority of TB patients who go there have received a diagnosis of TB but have not yet started threatment. So, from an IC point of view, this is what I plan to suggest, let me know what you think: 1. Patient with referral is triaged (no waiting in line) 2. Patient wears surgical mask. 3. Technician wears respirator 4. Clearance time of 15minutes using natural ventilation after patient leave before regular ENT clinic is resumes. (I know that 15 minutes clearance time is not much, but I doubt the staff will wait at all before bringing other people into the room no matter what education or policy is in place, that’s just how it is in our context, so I tried to pick a short time so that it might actually get done…) (Also the natural ventilation will likely only be one window in a single room opposite a door that the leads to the general corridor of the facility..)
Acceptable? Suggestions?
Best regards, Susan Adolph, RN ICO, MSF Uzbekistan/Tajikistan
I know that you're working under severely resource-constrained circumstances, so the following may not be immediately possible, but useful going forward.. Here in RSA we've started to pilot an innovative audiometery set which is designed to be used without a booth and can be used (where suPported by appropriate ICT infrastructure) in telemedicine. This is wonderful where there are a limited number of audiologists who can then support several sites remotely without having to have a physical presence.
Audiometery is a critical part of MDR TB care in our setting (precedent for litigation where deafness follows treatment). Yet there is a reluctance for this resource to be shared where there is a heightened risk for airborne infection prevention and control - as in enclosed booths.
Sent via my BlackBerry from Vodacom - let your email find you!
-----Original Message----- From: "GHDonline (Susan Adolph)" <> Date: Fri, 20 Jul 2012 01:43:32 To: Peta de Reply-To: TB Infection Control <> Subject: Re: [TB Infection Control] Audiometry room / test for MDR TB patients
Susan Adolph replied to the discussion "Audiometry room / test for MDR TB patients" in the TB Infection ...
I know that you're working under severely resource-constrained circumstances, so the following may not be immediately possible, but useful going forward.. Here in RSA we've started to pilot an innovative audiometery set which is designed to be used without a booth and can be used (where suPported by appropriate ICT infrastructure) in telemedicine. This is wonderful where there are a limited number of audiologists who can then support several sites remotely without having to have a physical presence.
Audiometery is a critical part of MDR TB care in our setting (precedent for litigation where deafness follows treatment). Yet there is a reluctance for this resource to be shared where there is a heightened risk for airborne infection prevention and control - as in enclosed booths.
Sent via my BlackBerry from Vodacom - let your email find you!
-----Original Message----- From: "GHDonline (Susan Adolph)" <> Date: Fri, 20 Jul 2012 01:43:32 To: Peta de Reply-To: TB Infection Control <> Subject: Re: [TB Infection Control] Audiometry room / test for MDR TB patients
Susan Adolph replied to the discussion "Audiometry room / test for MDR TB patients" in the TB Infection Control community.
Reply contents: "Hello all,
I have an additional question about TBIC for audiometry.
In our setting, the audiometry will be done in the office an ENT professional. These offices do not have booths but are supposedly a “quiet place”, quiet enough to perform audiometry. There is no option for this test to be performed in another location. The office is usually located in a large multidisciplinary, ambulatory facility. Understanably I have some concerns about this situation as the majority of TB patients who go there have received a diagnosis of TB but have not yet started threatment. So, from an IC point of view, this is what I plan to suggest, let me know what you think: 1. Patient with referral is triaged (no waiting in line) 2. Patient wears surgical mask. 3. Technician wears respirator 4. Clearance time of 15minutes using natural ventilation after patient leave before regular ENT clinic is resumes. (I know that 15 minutes clearance time is not much, but I doubt the staff will wait at all before bringing other people into the room no matter what education or policy is in place, that’s just how it is in our context, so I tried to pick a short time so that it might actually get done…) (Also the natural ventilation will likely only be one window in a single room opposite a door that the leads to the general corridor of the facility..)
Acceptable? Suggestions?
Best regards, Susan Adolph, RN ICO, MSF Uzbekistan/Tajikistan"
You can reply to this discussion by responding directly to this e-mail; it will be shared with all community members and posted as is. Files cannot be added via email attachment and must be uploaded directly to GHDonline.
-- This message is subject to the CSIR's copyright terms and conditions, e-mail legal notice, and implemented Open Document Format (ODF) standard. The full disclaimer details can be found at http://www.csir.co.za/disclaimer.html.
This message has been scanned for viruses and dangerous content by MailScanner, and is believed to be clean.
Please consider the environment before printing this email.
Nice to hear from you and hope you are well. You are right that your equipment is a nice suggestion for future. We have just purchased ours, and to be honest, I don’t know what kind or type it is, only that it came with instructions that a “quiet place” is acceptable. From start to finish the procedure only takes 10 to 20 minutes, so the duration of time the patient is in the building will be limited. But I want to ensure that short duration with these recommendations, particularly when you consider the likely vulnerability of the other non-tb patients in a multidisciplinary setting. The location and equipment is fixed (meaning it cannot be changed), so I have to work with what is.
Best regards, Susan Adolph, RN ICO MSF Uzbekistan/Tajikistan
S. Mehtar
It is a good question. If the patient is wearing a face mask (NOT an N95 respirator) then it should be fine as long as the patient is not coughing and there is good ventilation. If there is external noise it is very difficult to do a proper assessment. Yes there are systems with head phones but they are quite expensive.
Shaheen
Prof Shaheen Mehtar
MBBS, FRC Path (UK), FCPath (Micro) (SA), MD (Lon)
Chair of Infection Control Africa Network (ICAN)
Head of Academic Unit for Infection Prevention and Control
Tygerberg Hospital &Fac of Health Sciences, Stellenbosch Uni
PO Box 19063,
Tygerberg 7505, Cape Town
Tel: +27 21 938 5051
Fax: + 27 21 938 5065
Mobile: +27 82 852 3697
http://www.sun.ac.za/uipc
Visit the Infection Control Africa Network (ICAN) website on
http://www.ICANetwork.co.za
9:13 AM, 8 Feb 2012 | Permalink
Edward Nardell, MD
As Shaheen indicates, the booth is needed for silence, even with headphones. Since only the patient is in the booth, there should be no TB transmission control risk. Since booths tend to be small, they can be easily ventilated between patients with a simple exhaust fan (but not during testing because of noise). Tariq, was there more to your question?
5:32 PM, 9 Feb 2012 | Permalink
Susan Adolph
Hello all,
expand commentI have an additional question about TBIC for audiometry.
In our setting, the audiometry will be done in the office an ENT professional. These offices do not have booths but are supposedly a “quiet place”, quiet enough to perform audiometry. There is no option for this test to be performed in another location. The office is usually located in a large multidisciplinary, ambulatory facility. Understanably I have some concerns about this situation as the majority of TB patients who go there have received a diagnosis of TB but have not yet started threatment. So, from an IC point of view, this is what I plan to suggest, let me know what you think:
1. Patient with referral is triaged (no waiting in line)
2. Patient wears surgical mask.
3. Technician wears respirator
4. Clearance time of 15minutes using natural ventilation after patient leave before regular ENT clinic is resumes. (I know that 15 minutes clearance time is not much, but I doubt the staff will wait at all before bringing other people into the room no matter what education or policy is in place, that’s just how it is in our context, so I tried to pick ...
1:43 AM, 20 Jul 2012 | Permalink
Peta de Jager
Hi Susan,
expand commentI know that you're working under severely resource-constrained circumstances, so the following may not be immediately possible, but useful going forward.. Here in RSA we've started to pilot an innovative audiometery set which is designed to be used without a booth and can be used (where suPported by appropriate ICT infrastructure) in telemedicine. This is wonderful where there are a limited number of audiologists who can then support several sites remotely without having to have a physical presence.
Audiometery is a critical part of MDR TB care in our setting (precedent for litigation where deafness follows treatment). Yet there is a reluctance for this resource to be shared where there is a heightened risk for airborne infection prevention and control - as in enclosed booths.
Sent via my BlackBerry from Vodacom - let your email find you!
-----Original Message-----
From: "GHDonline (Susan Adolph)" <>
Date: Fri, 20 Jul 2012 01:43:32
To: Peta de
Reply-To: TB Infection Control <>
Subject: Re: [TB Infection Control] Audiometry room / test for MDR TB patients
Susan Adolph replied to the discussion "Audiometry room / test for MDR TB patients" in the TB Infection ...
2:28 AM, 20 Jul 2012 | Permalink
Susan Adolph
Hi Peta,
Nice to hear from you and hope you are well. You are right that your equipment is a nice suggestion for future. We have just purchased ours, and to be honest, I don’t know what kind or type it is, only that it came with instructions that a “quiet place” is acceptable. From start to finish the procedure only takes 10 to 20 minutes, so the duration of time the patient is in the building will be limited. But I want to ensure that short duration with these recommendations, particularly when you consider the likely vulnerability of the other non-tb patients in a multidisciplinary setting. The location and equipment is fixed (meaning it cannot be changed), so I have to work with what is.
Best regards,
Susan Adolph, RN
ICO MSF Uzbekistan/Tajikistan
2:44 AM, 20 Jul 2012 | Permalink
Edit Comment Text