Tympanometers

[jbrmdr]

Do any of you use a tympanometer? Is it helpful? I usually just use otoscope but had someone ask me recently if I had one and I was considering purchasing one?

Opinions?

[KKEGS, MSN, RN]

We don't even have otoscopes in my district. We use pure tone audiometry for our hearing screenings and that's all.

[iggywench, BSN, RN]

It would be nice to have one, but my budget doesn't allow for it. We are not required to have otoscopes, but most schools in my district do have one.

[JenTheSchoolRN, BSN, RN]

I have a pretty inexpensive otoscope:

Amazon.com: 4th Generation Dr Mom LED POCKET Otoscope and both Adult and Pediatric Disposable Specula Tips and Case.: Industrial & Scientific

Lets me see just enough to let me know if something is going on that might require a referral. I really only use it if a student is complaining of unilateral ear pain (vs. what I call ear "congestion"). It let me see a bug stuck in a student's ear once!

I don't use during hearing screenings, though. Just pure tone audiometry.

[ruby_jane, BSN, RN]

Just curious...does tympanometer move us from the realm of screening to the diagnostic realm?

Our policy dictates the screen with the audiometer. I have never even thought about using my otoscope to look and see if there was a blockage or if the TM looked bulgy. It's so rare that a kid fails a hearing screen here.

[JenTheSchoolRN, BSN, RN]

Just curious...does tympanometer move us from the realm of screening to the diagnostic realm?

Our policy dictates the screen with the audiometer. I have never even thought about using my otoscope to look and see if there was a blockage or if the TM looked bulgy. It's so rare that a kid fails a hearing screen here.

Same. Even those I've had fail, I'll rescreen the next week and they have passed.

[Cattz, ADN]

If I had the budget. I would love to have a tympanometer. I had one in my early days at my first school.

[Flare, ASN, BSN]

i also do pure tone. it's sufficient. In the years that i've been doing hearing screenings, i've only had one child that i've screened and found a hearing issue with. That child lost their hearing in one ear as a result of ear infections and now has an external cochlear device.

[mainecoonRN92, BSN, RN]

Our district does have a tymp and we do use it.

We are in colorado and per our hearing guidelines PreK-12 grade we test with pure tones first. Then if you are a district who has an audiologist that oversees your hearing screenings you can proceed with further testing if needed.

Our flow is:

Pure tones --- if no pass, then

Check with Otoscope (to ensure there is no obstruction) then

Perform an Otoacoustic Emissions (OAE) test bilaterally. ---- If no pass, then

Perform a tymp on failing ear ---- if no pass, then

Refer to the district audiologist.

Honestly it is nice to have the tymp but they are stupid expensive. The audiologist gives us yearly in-services to use the instruments. We own it all though. Truly, we use the OAE much more commonly then the Tymp.

[hellonurse62]

How do you teach your new school nurses on how to use the Tympanometer? I am a high school nurse and have only used it a handful of times. Is there somewhere we can direct our new nurse to help make her feel more confident in screenings?

[LikeTheDeadSea, MSN, RN]

Following thread for any answers to this. I lucked out that at one of my previous experiences I worked closely with a nurse who had worked in a pediatricians office for years so any kid she looked at, she'd have me look at and explain what was going on, but that only works in "luxury" 2 nurse environments, which are rare.

[Amethya]

Just got a normal audiometer that I get calibrated once a year and works wonderfully.