Pediatric otoscopy and case history

Question 1

Initial patient encounter

first impression are often lasting impression

Answer 1

audiologists strive to follow a humanistic approach in providing clinical services. Humanistic care is focused and centered on the patient and family and not based on primarily on the preconceptions and protocols of the healthcare provider

Question 2

prepare yourself mentally (4)

Answer 2

1) keep in mind patients are waiting for you

2) they are proabably less at ease and more frightened than you are

3) they probably think their problems is more serious than you do

4) They are probably coming to see you because they believe you can help them

Question 3

Why are more errors made?

Answer 3

Because of inadequate history taking and superficial exam than any other cause

Question 4

case history defined

Answer 4

planned professional conversation that enables the patient to communicate his/her symptoms feelings and fears to the clinician so as to obtain an insight into the nature of patients illness and his/her attitude towards them

Question 5

Why case history matters in pediatric audiological assessments

Understanding the Child:

Answer 5

provides essential information about the child’s development and health, offering insights into their cognitive and developmental status and helping estimate their auditory skills

Question 6

Why case history matters in pediatric audiological assessments

Understanding the family:

Answer 6

Enables the audiologists to understands the parents concern, needs, assessment expectations, and helps build rapport with family and caregivers which is crucial for effective counseling

Question 7

Why case history matters in pediatric audiological assessments

Observational Opportunities:

Answer 7

Allows the audiologists to observe the child’s behavior and note interactions with family members and others

Question 8

Why case history matters in pediatric audiological assessments

Guidance for Assessment:

Answer 8

Informs the audiologists about the nature of auditory complaints (unilateral/bilateral/ acute/chronic) assists in formulating clinical testing strategies and highlights possible contributing factors to hearing disorders

Question 9

consequences

Question 10

common pitfalls during case history collection

Answer 10

providing false reassurance
giving unwanted advice
using authority
using “why” questions
using professional jargon
using leading or biased questions
talking to much
interrupting or changing the subject

Question 11

collecting case history information

Answer 11

Interview
health questionnaire and combination

Question 12

Chief complaint

Answer 12

audiologists might make initially ask a simple question to elicit the chief complaint

” what brought you to see us today”

Question 13

Chief complaint:

open question

closed question

leading question

Answer 13

How can I help you

Do you still have pain in your left ear

You used your hearing regularly as you should, right?

Question 14

Components

Answer 14

complete history covers several content areas and depending on the reason for the evaluation, emphasizes different segments of information

Question 15

Examples of components

Answer 15

patient information
prenatal and birth history
medical history
growth and physical development
educational progress
hearing and auditory behavior
speech and hearing milestones
amplification
dizziness

Question 16

otoscopic examination

Answer 16

ensuring that the ear canal is free of debris through visual inspection is an important first step for diagnostic assessment

Question 17

2 reasons for otoscopic examination

Answer 17

understand the physical influences that can impact the outcome of the audiologic evaluation

determine that it is safe to preform audiologic testing involving the placement of probe tips and earphones into the ear canal

Question 18

selecting the speculum

Answer 18

should be observed based on childs external ear

best view will be obtained with a speculum tip slightly smaller than the ear canal diameter allowing it to be isnerted into the canal while providing the maximum lumen for viewing purposes

Question 19

pediatric audiologists need to

Answer 19

communicate on their level and be creative
engage the parents
build trust
make sure that you have the temperament, personality, and dedication required

Question 20

preparation
for infants and younger children under 3

Answer 20

children sit on patients lap

• protects the childs head from sudden movements that could cause injury
• hugging child reduces anxiety and increases cooperation

Question 21

preperation
for older children

Answer 21

invite them to play with otoscope demonstarting how it works and explaing how and why they need to stay still

Question 22

examination of the ear

Answer 22

shape (malformation)
placement
redness
swelling
discharge
pits/tags
cuts/scrapes, bruises
foreign object

Question 23

Examination of the ear canal

Answer 23

clear enough to allow the interstion of an admittance probe tip

free from excessive cerumen

free from other obstructions such as PE tubes that haven been extruded from the tympanic membrane

Question 24

examination of the ear canal

watch for

Answer 24

foreign object
redness
swelling
cerumen impaction
bony growth