Welch Allyn Audioscope 3 User manual

Portable
Screening
Audiometer
Operating
Instructions

AudioScope
®
— U.S. Patent No. 4,567,881
AudioSpec
®
— Patent No. 4,380, 8

Page 1
Contents
Warnings .................................................................................................2
Standards Compliance ........................................................................3
AudioScope 3 – Introduction .............................................................4
Hearing Loss .................................................................................4
Traditional Hearing Testing .........................................................5
Screening Audiometry .........................................................................7
Completing a Test .................................................................................8
Guidelines for Selection of Screening Level ................................ 12
20 dB HL ...................................................................................... 12
25 dB HL ...................................................................................... 12
40 dB HL ...................................................................................... 12
General Protocol ................................................................................. 13
Lamp and Battery eplacement ...................................................... 14
Cover Removal and Replacement ........................................... 14
Lamp Replacement .................................................................... 15
Battery Replacement .................................................................. 16
echarging ............................................................................................ 17
Method 1: Using Charging Stand ............................................. 17
Method 2: Using Charging Transformer .................................. 18
Method 3: Using MicroTymp Printer/Charger 18
Wall Mounting Instructions .............................................................. 1
Cleaning and Sterilization ................................................................. 20
Charging Transformer/Charging Stand ................................... 20
AudioScope 3 .............................................................................. 20
AudioSpecs ................................................................................. 20
AudioScope 3 Parts and Accessories ........................................... 21
Transformers (Charging) ........................................................... 22
Service, ecalibration and Warranty ............................................. 23
Service ......................................................................................... 23
Recalibration................................................................................ 23
Warranty ....................................................................................... 24
Technical Specifications ................................................................... 25
AudioScope 3 .............................................................................. 25
Charging Stand Specifications.................................................. 27
Charging Transformers .............................................................. 28
Circuit Diagram for Charging Transformers ............................ 28
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Warnings
WA NING: efer to Owner’s Manual.
Use with Welch Allyn Charging Stand (#71123, #71126);
Direct Plug-In Chargers (#71040, #71032, #71034,
#71036) and/or MicroTymp Printer/Chargers (#71130,
#71135, #71170, #71175) only.
Use with approved accessories only.
Lamp may be hot after use. Use caution during
replacement.
Not for use in the presence of flammable anesthetics.
For Service in North America, instrument should be
returned to an authorized Welch Allyn distributor or to
Technical Service Department, Welch Allyn, Inc., 4341
State Street oad, Skaneateles Falls, NY 13153-0220
U.S.A. Telephone: [phone] (U.S.A. ONLY) O
315-685-4560; 1-800-561-8797 (CANADA ONLY) O
416-890-0004.
AVE TISSEMENT : Se référer au Manuel de
l’operateur.
N’utiliser qu’avec le socle de charge Welch Allyn
(n° 71123, 71126), les chargeurs directs enfichables
(n° 71040, 71032, 71034, 71036) et/ou les imprimantes/
chargeurs MicroTymp (n° 71130, 71135, 71170, 71175).
N’utiliser qu’avec les accessoires agréés.
La lampe peut être brûlante après l’emploi. Observer
des précautions en la remplaçant.
Ne pas utiliser en présence d’anesthésiques
inflammables.
Clients situés en Amérique du Nord : réexpédier
l’instrument à réparer à un distributeur agréé Welch
Allyn ou au centre de service Welch Allyn suivant
uniquement : Technical Service Department, Welch
Allyn, Inc., 4341 State Street oad, Skaneateles Falls,
NY 13153-0220 U.S.A. Téléphone: 800-669-9771 (É.U.
UNIQUEMENT) ou 315-685-3445 ; 1-800-561-8797
(CANADA UNIQUEMENT) ou 416-890-0004.
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Standards Compliance
The Model 23300 AudioScope 3 complies with the following
standards to the extent that they apply to this instrument:
Type BF equipment
ANSI S3.6-1969 ( 1973): Standard for Audiometers
IEC 645-1979: Standard for Audiometers
ETL listed: UL2601, CSA C22.2, No 601-1, IEC 601-1
71040 Only: UL ecognized, CSA Certified
Warnings
and Standards
Compliance
3

Page 4
AudioScope 3 – Introduction
Thank you for purchasing the AudioScope 3. The operating and
maintenance instructions found in this manual should be followed to
ensure many years of accurate and reliable service. Please read
these instructions thoroughly before using your new AudioScope 3.
HEA ING LOSS
The Invisible Handicap Role of the Professional/Paraprofessional
Over 20 million people in the United States (one out of every 15
individuals) suffer from hearing loss. Many other countries report
similar statistics.
Hearing problems can affect an individual’s social adjustment,
speech and Ianguage development, academic progress, as well as
the psychological well-being of that individual and his or her family.
Fortunately, most hearing problems can be very successfully
addressed through medical treatment and/or aural rehabilitation.
The crucial element and first step is early detection, and it is here
that professionals and paraprofessionals play a vital role.
While audiologists and otolaryngologists are specially trained for
testing and treating ear diseases, the primary care setting is ideally
suited for first and early detection of the problem, since people fre-
quently visit these groups: pediatricians, family practitioners, gener-
al practitioners, speech-language pathologists, nurse practitioners,
physician assistants, public health personnel, school health nurses
and volunteers.
With a fast, simple, accurate method of hearing screening, early
detection and appropriate referrals can be more efficiently and
effectively accomplished.
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T ADITIONAL HEA ING TESTING
Tuning forks were one of the first methods used to determine the
type of hearing loss. They may still be used by some to differenti-
ate between conductive and sensorineural losses. However, they
have in great part been replaced by the audiometer.
Traditional audiometers produce pure tones of varying frequency
and intensity. Frequency is measured in Hertz (Hz) or cycles per
second, and is perceived as pitch. Human hearing ranges from
approximately 20 to 20,000 Hz. Intensity is measured in decibels
(dB) and is perceived as loudness.
Most often, hearing is measured by specialists in terms of thresh-
old, or the faintest sound which an average listener can just hear in
the quiet. Thresholds are measured at various frequencies, usually
in the speech range (500 Hz to 4000 Hz) and just beyond (125 Hz
to 8000 Hz).
The magnitude or degree of loss is recorded on a form called an
audiogram shown on Table 1 (p. 6).
Measurements are made by air conduction, where the sound is
introduced through a headphone into the ear. Measurements may
also be made by bone conduction, where the sound is introduced
through a vibrator which is placed on the mastoid bone behind the
ear. By comparing these two measurements, the type of loss (con-
ductive, sensorineural or mixed), can be determined.
Introduction
3AudioScope
–
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TABLE 1
Audiogram Showing Scale of Hearing Impairment*
Fre uency in Hz
Hearing
Level (HL)
in dB
ANSI 1 6
NORMAL
MILD
MODERATE
MODERATELY SEVERE
SEVERE
PROFOUND
*Katz, J. “Handbook of Clinical Audiology,” Williams & Wilkins, 1 85.
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Screening Audiometry
The process of threshold and bone conduction testing can be time-
consuming and costly in terms of equipment and personnel. Such
testing should be done in a soundproof room.
This is not practical for many people for detection purposes.
Therefore, many use a traditional audiometer but conduct a screen-
ing audiometric test.
Generally, screening is conducted at 20 dB HL, 25 dB HL or
40 dB HL using the speech frequencies (500 Hz, 1000 Hz,
2000 Hz, 4000 Hz). Individuals who fail to respond at one or
more frequencies in either ear are then referred.
This type of hearing screening is often done in school systems at
several grade levels and by speech-language therapists in private
practice. RARELY IS SCREENING PERFORMED IN OTHER
NEED-ED AREAS: in the physician’s office as part of a routine
physical examination; in each and every school grade; hospital
admitting; pediatric and ENT areas; nursing homes; high schools
and col-leges; industrial areas; public health clinics; and health
mainte-nance organizations.
The Welch Allyn AudioScope 3 provides a unique means for accu-
rate and efficient early detection of hearing loss.
AudioScope 3 provides screening at the speech frequencies of
1000, 2000, 4000 and 500 Hz respectively, at a fixed decibel level.
Choices of decibel levels include: 20 dB HL, 25 dB HL and 40 dB
HL. Prior to the screening tones a practice tone or pretone (PT) is
delivered at 1000 Hz and at 20 dB HL above the screening level.
For example:
When Screening at: The 1000 Hz Pretone is set at:
20 dB HL 40 dB HL
25 dB HL 45 dB HL
40 dB HL 60 dB HL
The pretone allows the patient to hear a test tone at a level which
is more audible than the screening level itself, thus allowing for
practice.
Screening Audiometry
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Completing a Test
1. Before starting, check that the lens is centered in the instrument.
2. Select an area that is relatively quiet and free from distracting
conversation, fan noises, etc. (see p. 27 for allowable ambient
noise specifications).
3. Select a small, medium or large AudioSpec ear speculum. Use
the largest speculum that can be inserted comfortably into the
ear canal, yet still allow visualization of the tympanic membrane.
A snug fit assures an acoustic seal of the speculum in the ear
and occludes ambient noise. Secure the AudioSpec to
AudioScope 3 by twisting it clockwise onto the instrument.
NOTE: Use only gray-tipped Welch Allyn AudioSpecs.
Other types of specula will cause inaccurate results.
4. Turn AudioScope 3 “ON” by sliding the selection switch to the
desired screening level (20 dB HL, 25 dB HL, or 40 dB HL; see p.
12 for guidelines). The white indicator band should completely fill
the square next to desired sound level. The green “READY”
indicator will become illuminated indicating that the instrument is
ready for service.
Should the yellow “LO BATT” indicator illuminate, see recharging
instructions (p. 17 - p. 18).
Lens Low Battery
Tone Indicator
Indicators
Pretone dB Level
and ON/OFF
Indicator Switch
“READY”
Indicator
Start
Button
Centering
the lens
Charging
Jack
Step 1 Step 4
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Page 9
5. Instruct the patient that he/she will hear a loud tone (or beep) and
then some fainter tones (or beeps). The patient is to respond
every time a tone is heard. Responses can be verbal (“yes” or
“beep”), gross motor (raising a hand, dropping a block in a
bucket, waving a paper towel), or fine motor (raising a finger).
Very young children may respond better via a verbal response,
whereas seniors seem to perform better via a gross motor
response.
Children as young as four years of age may be tested with this
instrument.
1
Limitations in screening younger children are behav-
ioral, not physiological, and are due to the interactive nature of
the test. It is particularly important to reduce all sources of dis-
tracting auditory and visual stimuli. It is recommended that chil-
dren be seated in such a position that they face a blank wall.
Very young or uncooperative children should be referred to an
audiologist since special procedures are required with these
patients.
Examination of data by age groups indicates that the AudioScope
screening procedure shows good validity in predicting categories
of hearing acuity for subjects age 5 and older. For 3-year-old
subjects the error rates were significantly higher. While error rates
in the 4-year-old population were somewhat higher than the older
subjects, the error rates were not so high as to make AudioScope
screening unfeasible. Of those subjects in the 3-to-4-year-old age
group who showed errors on the screening pro-cedure, all but two
showed poor cooperation with both pure tone threshold
audiometry and the screening technique. In view
Step 4
Completing a Test
1. Bienvenue, G., Michael, P., Chaffinch, J., Zeigler, J. — “The AudioScope™, A Clinical Tool for
Otoscopic and Audiometric Examination,” Ear and Hearing, Sept./Oct., 1 85.

Page 10
of the general findings, it appears that the AudioScope can be
used successfully with patients aged 4 years and older; howev-
er, care must be exercised to note the level of cooperation
among the younger subjects.
2,3,4
6. Retract the patient’s pinna with the thumb and index finger.
Gently pull it slightly up and back. With children, the pinna
should be pulled back more than up. This facilitates insertion of
the tip.
7. Grasp AudioScope 3 and gently insert speculum tip into the ear
canal.
NOTE: The handle may also be held in a horizontal position.
Use little finger to stabilize instrument with respect to
patient’s head.
8. Position the tip so that the tympanic membrane or a portion of it can
be visualized. This visualization ensures free passage of sound.
Step 6 Step 7
2. Gershel, J., Kugler, B., et. al., The Albert Einstein College of Medicine — “Accuracy of the
Welch Allyn AudioScope™ and Traditional Hearing Screening for Children with Known
Hearing Loss,” The Journal of Pediatrics, January, 1 85.
3. Frank, J., Peterson, D. — “Accuracy of a 40dB HL AudioScope™ and Audiometer Screening
for Adults,” Ear and Hearing, March, 1 87.
4. Gershel, J., Giraudi-Perry. D., et. al., The Albert Einstein College of Medicine — “Comparison
of Hearing Screened with the Welch Allyn AudioScope™ and a Traditional Audiometer,”
Presented at ASHA, 1 85.
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Do not attempt to perform procedures through the AudioScope
3 cavity. This may result in damage to the sound delivery
system of AudioScope 3 or inaccurate readings. If the tympanic
mem-brane is significantly occluded by wax, the ear should be
cleaned prior to performing the hearing screen. Excessive wax
may reduce the hearing sensitivity of a patient.
. Maintain AudioScope 3 in the same position and depress the
“START” button. The green light will then go out, and tone
indicators which show the tone being presented will light
sequentially.
10. Observe each tone indicator and the patient’s response. If, for
any reason (i.e. patient movement, excessive ambient noise,
etc.), the test is disrupted, it may be restarted at any time by
depressing the “START” button again. It is important to keep
AudioScope 3 stationary during the test to prevent generation
of noise.
11. Repeat Steps 5 through 10 on the opposite ear. Rescreen if
necessary (see General Protocol, page 13).
12. Turn the instrument “OFF” by sliding selection switch down.
13. Complete the AudioScope Screening Results form and attach it
to patient’s chart.
Completing a Test
EXAMPLE ABOVE: All tones heard in left
ear, none heard in right ear.
Step 10 Step 13
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Guidelines for Selection of Screening Level
20 DB HL
This is a typical screening level for the school-aged child.
Although 25 dB HL is regarded as the upper limit for normal
hearing
2
, one would expect the young child’s hearing acuity to
be better than that of the adult.
Therefore, American Speech Language Hearing Association
(ASHA) guidelines for screening school children recommend use of
20 dB HL at 1000, 2000, and 4000 Hz with 500 Hz to be included if
ambient noise levels permit.
3
Ambient noise levels are a concern when screening at this level. It
may be advisable to have room noise levels tested before using
this level routinely (see p. 27 for maximum permissible noise
levels).
25 DB HL
This is a standard screening level used with adults, and with chil-
dren in situations where ambient noise prohibits use of 20 dB HL.
40 DB HL
This is a screening level which may be used to assess hearing
impairment in those people aged 65 and above. Typically, failure at
any frequency except 4000 Hz necessitates referral. An inability to
hear 4000 Hz accompanied by inability to hear at least one other
frequency also necessitates a referral.
There is a debate in the audiological community as to the appro-
priateness of a 25 dB HL screen for seniors (those aged 65 and
above). Many feel the question becomes one of identifying per-
sons whose hearing impairment poses a handicap as opposed to
the question of normal hearing. Many researchers
4
propose 40 dB
HL as the level of choice for this age group.
AudioScope 3 gives you the flexibility of screening at 25 dB HL,
40 dB HL or both.
2. Katz, J. “Handbook of Clinical Audiology,” Williams & Wilkins, 1 85
3. American Speech Language and Hearing Association, “Guidelines for Identification
Audiometry,” ASHA, May 1 85
4. Dalzell, L.E., PhD, Puccia, Swirat, D., M.A., Dept. of Audiology and Speech Pathology,
Strong Memorial Hospital, “Hearing Loss, Hearing Handicap, and Hearing Aid Candidacy in
Geriatrics,” presented at ASHA, 1 83
Weinstein, B. E., St. John’s University, “Validity of a Screening Protocol for Identifying
Elderly People with Hearing Problems,” ASHA, May 1 86
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General Protocol
Many professional and state guidelines suggest the following:
If there is a failure at one or more frequencies in either ear, instruct
the patient again and screen again.
Failure at one or more frequencies on the second trial constitutes
failure on the screen. (See specific instructions above for seniors.)
Failure on a second screen indicates the need for further testing.
The patient should be referred to an audiologist and/or otolaryn-
gologist.
IMPORTANT: A diagnosis or prescription for a hearing aid or
drugs should not be made solely on the basis of AudioScope 3
results. This instrument is a screening device designed to
identify people at risk for hearing loss and is to be used by the
Professional to make appropriate referrals.
General Protocol
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Lamp and Battery eplacement
COVE EMOVAL AND EPLACEMENT
If the lamp or battery is to be replaced, it is necessary to first
remove the instrument cover:
1. Disconnect the charging transformer from AudioScope 3 and
turn the instrument “OFF” before beginning.
2. Insert a coin into the slot of the lock mechanism at the end of
the handle.
3. Turn the coin in either direction until the line under the word “OPEN”
on the lock is aligned with the recessed line on the housing.
Step 2 Step 3
4. Slide the cover back (away from the speculum end), until the
arrows on the instrument case align.
5. Lift the cover.
NOTE: Once the cover is removed, care should be taken not to
touch any of the internal components except as described in
this manual.
Step 4
Step 5
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Page 15
LAMP EPLACEMENT
To remove old lamp:
1. Turn AudioScope 3 “OFF.”
2. LAMP MAY BE HOT—ALLOW TO COOL
BEFO E P OCEEDING.
3. Follow instructions for cover removal (page 14).
4. Depress the blue lamp ejector lever (see Figure 1 below). The
lamp will pop up.
5. Grasp lamp and remove.
Fiber Optic Bundle
Beveled end of lamp
Lamp ejector lever
Figure 1
To insert new lamp:
1. For best performance of Halogen lamps, remove any dirt or
fingerprints from glass with a clean cloth moistened with 70%
Isopropyl Alcohol before inserting lamp. Failure to follow clean-
ing procedures will result in permanent stains on the glass with
reduction in light output. Average lamp life is 20 hours of on-
time.
2. Rest lamp on lamp holder bracket with beveled end of lamp
toward fiber optic bundle (see Figure 1 above).
3. Push lamp into lamp holder.
4. Follow instructions for cover replacement (page 16).
NOTE: Replace with Welch Allyn No. 06200 lamp only. Other
lamps may cause damage to the instrument or may cause
inaccurate readings.
15
Lamp and Battery
Replacement

Page 16
BATTE Y EPLACEMENT
Turn AudioScope 3 “OFF”. Remove the cover and lift out the bat-
tery. Observe polarity markings when installing new battery.
NOTE: Replace with Welch Allyn No. 72300 only.
COVE EPLACEMENT
The cover may be replaced in the opposite manner in which it was
removed:
1. Place the cover over the instrument so that the arrows on the
cover and the housing are aligned.
2. Press down gently on the cover and slide it up toward the
speculum end of the instrument.
3. Return the lock mechanism to the locked position.
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echarging
The 3.5v nickel cadmium battery used in this instrument will provide
approximately 50 minutes of continuous operation. When the bat-
tery is low, the yellow “LO BATT” indicator will illuminate and
AudioScope 3 will automatically shut off, thereby preventing incor-
rect results due to inadequate battery voltage. Viewing illumination
will remain on for a period of time after the low battery indicator
becomes illuminated. The instrument may be recharged using any
of the following three methods:
METHOD 1: USING CHA GING STAND
THIS CHARGING STAND CAN BE USED ON A DESK TOP
OR MOUNTED TO A WALL:
1. Turn AudioScope 3 “OFF”.
2. Plug the output cord of the charging transformer into the jack of
the charging stand.
3. Plug the charging transformer into a power receptacle of appro-
priate voltage, frequency and plug configuration. (No. 71040
Charging Transformer shown; see p. 22 for others.)
4. Place AudioScope 3 in charging stand. Handle will fit into well
only one way.
5. By leaving AudioScope 3 in the charging stand, a fully charged
instrument is always ready for use. Battery can be charged
indefinitely without damage. A completely discharged battery
can be fully charged overnight.
Method 1
Handle will fit into well ONLY ONE WAY
Handle receptacle for charging
AudioScope 3
Four posts for storing Welch Allyn
AudioSpecs
Indicator light illuminates when
instrument is charging properly
Charging Transformer
Recharging
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METHOD 2: USING CHA GING T ANSFO ME
1. Turn AudioScope 3 “OFF”.
2. Plug the charging transformer into a power receptacle of appro-
priate voltage, frequency and plug configuration (see p. 22).
3. Plug the output cord of the charging transformer into
AudioScope 3 charging jack.
4. Place the instrument on its side.
AudioScope 3 will not operate while recharging. A fully drained
battery can be recharged overnight. The instrument can be left
charging indefinitely without damage to instrument or battery. For
longest battery life, use the instrument for at least 20 examinations
before recharging, and vary the number of uses between
recharges.
Method 2
(71040 Charging
Transformer shown)
Step 2b
Step 2c
METHOD 3: USING MIC OTYMP
P INTE /CHA GE
The Printer/Charger for the Welch Allyn MicroTymp (Models 71130,
71135, 71170, 71175) may also be used to charge AudioScope 3.
Follow instructions above for charging stand.
NOTE: The bottom portion of AudioScope 3 handle will become
slightly warm during recharging.
18