Earscan 3 ES3S Users Guide Rev 1.12

Precautionary Notes: Earscan® 3S Audiometer 1. Use only the factory-supplied, UL approved, power adapter (wall cube) with the ES3S. Use of any other power adapter will invalidate the warranty and may result in damage to the audiometer. 2. The ES3S is designed for use with alkaline 1.5 volt AA size batteries. If re-chargeable batteries are used, they must be of the alkaline type. Do not use nickel-metal hydride (NiMH) or nickel cadmium (NiCad) rechargeable batteries. 3. When installing batteries in the ES3S, you must observe the correct polarity. If one or more cells are installed with reversed polarity, the instrument will not operate in the battery-powered mode, and the audiometer may be damaged. 4. The ES3S is capable of producing signal levels greater than 100 dB SPL. Prolonged exposure to signals at these levels can result in temporary threshold shift or permanent hearing loss. When testing in manual mode at high HTL settings, limit signal duration to no more than 1 second. 5. If the ES3S has only external power available (low batteries or no batteries installed), be aware that unplugging the mini DIN connector will result in power loss and potential data loss. If it is necessary to disconnect the mini DIN in this case (e.g., to switch from USB cable to printer cable), it is advisable to turn the instrument off, make the cable change, then turn the instrument back on. 6. The ES3S does not implement handshaking protocol on the serial port. This means that it will not detect an unconnected serial port or a ‘printer not ready’ condition. ®

Earscan is a registered trademark of Micro Audiometrics Corporation. ® ® E·A·R and E·A·RTONE are registered trademarks of Aearo Company. Information in this manual is believed to be accurate; however, Micro Audiometrics Corporation assumes no responsibility for its use. Content is subject to change without notice. No part of this manual may be reproduced without written permission. Copyright © 2004-2007 Micro Audiometrics Corporation. PN: 95.706.112

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Table of Contents Introduction ... 6 Manual Conventions ... 6 Keypad ... 7 Menu Navigation... 7 Function Keys ... 8 Setup ... 9 Cable Connections ... 9 Power Up... 9 Power Options ... 10 Beep Volumes ... 10 Talk Over ... 11 Time and Date ... 11 Manual Audiometry ... 12 Manual Audiometry Key Functions ... 13 Testing Procedure ... 14 Manual Audiometry Options ... 14 Frequency Selection ... 14 Other Options... 15 Automatic Screening Audiometry... 16 Automatic Screening Function Key... 17 Testing Procedure ... 17 Automatic Screening Audiometry Options ... 17 Frequency Selection ... 17 Level Selection... 17 Sequence Direction... 18 Ear to Test First... 18 Test Results... 18 Displaying Results on the LCD ... 18 Display Results Key Functions... 19 Quantifying Hearing Loss ... 19 Serial Communications ... 20 Transmit Options ... 20 3

Screen and Clock Options... 20 Screen Properties ... 21 Power-Up Logo... 21 Real-Time Clock Settings ... 21 Lock Settings... 22 Reset Settings ... 22 Firmware Upgrade... 22 Headset Management ... 23 Calibration ... 24 Technical Specifications ... 25 Functional ‘Quick Checks’ ... 26 Trouble Shooting Guide ... 27 External Interface ... 28 Connectors ... 28 Multi-purpose Connector ... 28 Headset Connector ... 29 DPU-414 Printer Switch Settings ... 29 Earscan 3 Information... 30 Warranty... 31 Contact Information ... 32

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List of Tables TABLE 1. POWER SETTINGS ... 10 TABLE 2. MANUAL AUDIOMETRY KEY FUNCTIONS ... 13 TABLE 3. OTHER MANUAL AUDIOMETRY OPTIONS ... 15 TABLE 4. DISPLAY TEST RESULTS KEY FUNCTIONS ... 19 TABLE 5. SCALE OF HEARING LOSS... 19 TABLE 6. DATA TRANSMIT OPTIONS ... 20

List of Figures FIGURE 1. KEYPAD ... 7 FIGURE 2. MAPPING FUNCTION KEYS TO LCD TEXT... 8 FIGURE 3. MANUAL AUDIOMETRY DISPLAY ... 12 FIGURE 4. DISPLAY OF THRESHOLD ... 13 FIGURE 5. SCREENING AUDIOMETRY DISPLAY ... 16 FIGURE 6. AUDIOMETRIC TEST RESULTS DISPLAY ... 18 FIGURE 7. INFORMATION DISPLAY ... 30

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INTRODUCTION The Earscan 3 model ES3S is a pure tone, full frequency air conduction audiometers with talk over. It provides manual/automatic screening and manual threshold test capability. Options are available which provide higher nominal test levels (100 dB vs. 80 dB HTL, respectively) and the capability to support dual headsets. The ES3S is an easy to use audiometer with considerable functionality. It is user customizable, can be battery or AC powered, and offers flexibility in communications. One of the most powerful features of the instrument is the ability to be updated or upgraded via a PC attached to the Internet. Using factory supplied software, firmware updates/upgrades can be downloaded from the Micro Audiometrics website and installed on the ES3S. Micro Audiometrics will be periodically adding new features to the firmware, and these features can be downloaded from the Micro Audiometrics website or obtained from an authorized Micro Audiometrics distributor.

Manual Conventions The following conventions are used to indicate interactions with ES3S: KEY Presses appear in { }; e.g. {▲} means press the ▲ key. Basic menu navigation is done using {▲} / {▼} and {◄} / {►}. Use the {Ο} key to present tones, select menu items, or select list items. It’s the navigation key in the center of the array:

▲ ◄ Ο ► ▼ Menu sequences appear as ⌐MENU1 ⌐MENU2 ⌐MENU3. The “⌐” symbol is used to indicate “scroll to Menu Item and press the Ο key”. Use {◄} / {►} to select digit position and {▲} / {▼} to scroll through digits when entering time, date, and ID numbers.

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Keypad The ES3S audiometers have a green keypad/overlay and 5 unlabeled keys (see Figure 1). The numbers in outline (e.g., ) are used to represent key positions for reference purposes.

Figure 1. Keypad E S 3 S 5

u n l a b e l e d

k e y s

N u m b e r s i n d i c a t e K e y p o s i t i o n s

Menu Navigation The menu system is designed for intuitive use. Navigating through menus is as simple as using the {▲}, {▼}, {►}, or {◄} keys to highlight a selection and then pressing {Ο} to make a selection. The {Menu} key is used to exit test mode and enter the menu system, and also to move from ‘lower’ to ‘higher’ menu screens. Press {Menu} while in manual audiometry mode to enter the ‘top level’ of the menu system. If the user has navigated ‘down’ into the menu structure, each {Menu} press will return to the next ‘higher’ menu level until the ‘top level’ menu is reached. Menu sequences shown in this guide assume that the user begins at the ‘top level’ menu.

Note: The ‘top level’ menu can always be reached by repeatedly pressing {Menu}.

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Function Keys At times, ‘actions’ or ‘toggles’ will be displayed on the bottom line of the LCD. The keys just below the display are then used as ‘function’ keys to perform an action (A), or to toggle between two possible parameter values (a/b). Figure 2 illustrates how keys are mapped to actions or toggles shown on the LCD.

Figure 2. Mapping Function Keys to LCD Text U p p e r s c r e e n a r e a d i s p l a y s t e x t . L a s t l i n e m a y d i s p l a y t e x t O R f u n c t i o n k e y a s s i g n m e n t ; e . g . ,

A u t o

L / R

S e n d

C l r

T a l k

In this illustrative example, there are four ‘Actions’ (Auto, Send, Clr, and Talk) assigned to ‘Function’ keys , , , and . Press { } to perform action Auto, { } to perform the action Send, { } to perform action Clr, and { } to perform action Talk. The ‘L/R’ shown above { } indicates an L/R toggle with ‘R’ currently selected. Pressing { } will toggle between the two possible states, and the state selected will be highlighted (e.g., R).

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SETUP Cable Connections ES3S audiometers can be powered by 4 AA Alkaline batteries (battery compartment is accessible from the back of the instrument). Optionally, power from an AC adapter or USB bus power can be supplied via the 6-pin multi-purpose “mini DIN” connector on the top of the instrument. The AC adapter may be plugged directly into the ES3S mini DIN socket if serial communication is not required, or it may be plugged into the power adapter receptacle at the end of a printer cable or optional computer interface cable (RS-232). The headset and response button cable assembly plugs into the 15-pin connector on the top of the instrument. For installations that require patching through a booth wall, optional booth adapter and headphone adapter cables are available. The booth adapter cable replaces the headphone/response button cable and terminates in three ¼” phone plugs compatible with standard booth patch panels. The headphone adapter cable provides ¼” mono phone plugs for TDH-39 headphones.

Power Up Press the {On} key, and the ES3 logo will scroll onto the screen unless scrolling has been disabled (see Power Up Logo), or the instrument was last powered down due to an inactivity time-out. When power-up initialization is completed, enter {1} to begin a new test or enter {2} to continue a previous test automatically saved by the ES3 at its last power down. If you choose to begin a new test, the ES3S will prompt you to enter the Patient ID and an Operator ID. The manual audiometry screen will then be displayed and the instrument is ready to begin testing. Note: When the ES3S powers down due to an inactivity timeout or in response to ⌐TURN OFF, current test data is automatically saved to non-volatile memory. This prevents loss of data in case a test is interrupted. When the ES3S is powered back on, pending data will be restored and the test can be continued, if desired, or a new test can be started.

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Power Options Inactivity timeouts automatically turn off the LCD backlight and power after selectable periods of inactivity to conserve energy and extend battery life (see Table 1; ( ) indicates default setting). Note: The backlight requires considerable battery power. Setting the backlight power-down interval longer than necessary will decrease battery life when the ES3S is battery powered (see Screen Properties).

Table 1. Power Settings AC Backlight ⌐SETUP ⌐POWER ⌐A/C ⌐BACKLIGHT

AC Power Down ⌐SETUP ⌐POWER ⌐A/C ⌐POWER DOWN

Battery Backlight ⌐SETUP ⌐POWER ⌐BATTERY ⌐BACKLIGHT Battery Power Down ⌐SETUP ⌐POWER ⌐BATTERY ⌐POWER DOWN

(Never) 30 seconds 1 minute 2 minutes 5 minutes Never 1 minute 5 minutes (15 minutes) 30 minutes 1 hour 5 seconds 10 seconds (20 seconds) 30 seconds 1 minute 15 seconds 30 seconds (1 minute) 2 minutes 5 minutes

Beep Volumes Key presses are silent when in test mode, but produce audible ‘beeps’ when in the menu system. The volume of these beeps can be set via the menu sequence ⌐SETUP ⌐BEEP VOLUMES ⌐KEY VOLUME {Low/Medium/High}. The ES3S also produces an alert sound when certain errors occur and to indicate the completion of an automatic test. The volume of this alert can be set via the menu sequence ⌐SETUP ⌐BEEP VOLUMES ⌐ALERT VOLUME {Low/Medium/High}.

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Talk Over Talk over mode may be entered by pressing { } while in audiometric testing mode. There is no specific microphone ‘opening’; sound arrives at the microphone through other openings in the cabinet (e.g., the slot in the side). Talk over volume may be adjusted with the {◄} / {►} keys. It is recommended that a normal speaking voice be used at a distance of 1 to 2 feet, and volume adjustment used to compensate for hearing status of the listener. Press {1}, {Menu}, or {Ο} to exit talk over.

Time and Date The ES3 has a battery-backed up real time clock to maintain time and date. The clock is set at the factory prior to shipment. See section Real-Time Clock Settings for details on how to check or set the time and date. The backup battery is a lithium rechargeable type and will be recharged whenever ES3 power is on. Note: If the ES3 is not powered up for many months, the battery may become discharged. In this case, the time and date will need to be reset and the instrument should be left powered up for some time to recharge the clock battery. Normal instrument usage is sufficient to keep the battery fully charged.

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MANUAL AUDIOMETRY To insure that pending data is cleared, always begin a new test via the main menu sequence ⌐NEW TEST to clear pending test data. When the ES3S enters the manual audiometry mode, the screen format shown in Figure 3 will be displayed (assumes factory defaults for starting frequency and level).

Figure 3. Manual Audiometry Display F r e q u e n c y L e v e l E a r

1 0 0 0 2 0 R i g h t

H z d B

U n t e s t e d

A u t o

L / R

S e n d

C l r

T a l k

Once a threshold has been obtained, the display will change to show the threshold value (the ‘m’ indicates threshold was obtained via manual testing).

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Figure 4. Display of Threshold F r e q u e n c y L e v e l E a r

A u t o

L / R

1 0 0 0 2 0 m R i g h t

S e n d

C l r

H z d B

T a l k

The threshold may be cleared (Clr) by pressing key “ ” (e.g., to retest a threshold). Only the currently-displayed threshold is cleared. The test ear, signal mode, starting frequency and starting level are all user selectable, so these values may differ from the ones shown. The example shown indicates that a threshold of 20 dB has been obtained for the right ear at 1000 Hz.

Manual Audiometry Key Functions Table 2 lists the functions of keys that are active in the manual audiometry mode. The second column indicates the action of the function keys.

Table 2. Manual Audiometry Key Functions {◄}/{►}

Select next lower/higher enabled frequency (Hz)

{▲}/{▼}

Increase/decrease level by current step size (dB)

{ }

Auto

Exit manual test mode and enter automatic test mode

{ }

L/R

Toggle between Left and Right ear

{ }

Send

Send the test data to computer or printer

{ }

Clr

Clear the current threshold

{ }

Talk

Exit test mode and enter talk over mode

{Menu}

Exits manual test mode and enters the menu system

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Testing Procedure 1) Instruct the patient to raise his/her hand or press the patient response button (if available) whenever a tone is heard. 2) Position the headphones over the patient’s ears (Red over Right ear, Blue over Left ear). 3) Press { } if necessary to toggle to the desired test ear. 4) Select the test frequency using the {◄} / {►} keys. 5) Use the {▲} / {▼} keys to adjust the hearing level and press the {Ο} key to present the stimulus to the selected ear. When testing with Continuous signals, stimulus duration should be about 1 second; the minimum duration allowed is 200 ms. 6) Continue using the {▲} / {▼} and {Ο} to present stimuli consistent with the test paradigm being used (typically Hughson-Westlake) until threshold is determined. 7) Use the {◄} / {►} keys to select the next frequency to test. 8) Repeat steps 4 through 7 until threshold has been determined for each frequency for the selected ear. 9) Change the test Ear by pressing { }. 10) Repeat steps 4 through 8 until threshold has been determined for each frequency for the second ear.

Manual Audiometry Options Frequency Selection The frequency set to be used for manual testing may be viewed or modified via the menu sequence ⌐SETUP ⌐AUDIOMETRY SETUP ⌐FREQUENCIES. The display will show the list of available test frequencies and there will be a check mark (√) next to the ones currently selected for testing. Use the {►}, {▲}, {▼} and {◄} keys to move the highlight to a frequency to select or deselect for testing, and press {Ο} to toggle between ‘selected’ and ‘deselected’. Repeat this process as necessary to select or deselect other frequencies. The default frequency set includes 250, 500, 1000, 2000, 3000, 4000, 6000, and 8000 Hz, plus the 1k/Validity check. Once selections are completed, press {Menu} to exit frequency selection mode and return to the menu system.

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Other Options Additional manual audiometry options listed in Table 3 may be accessed via the menu sequence ⌐SETUP ⌐AUDIOMETRY SETUP ⌐MANUAL AUDIOMETRY. To change an option, highlight the option to modify using the {►}, {▲}, {▼} and {◄} keys, and press {Ο}. Use the {►}, {▲}, {▼} and {◄} keys to select the desired setting for the option, and press {Ο}.

Table 3. Other Manual Audiometry Options Ear Level Frequency Tone Mode Increment Size Decrement Size

Ear to be tested first. Initial level when new test is started Initial frequency when entering manual test mode Stimulus mode Increment step size Decrement step size

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Left, (Right) 10, 15, (20), 25, 30, 35, 40 125, 250, 500, (1000), 1500, 2000, 3000, 4000, 6000, 8000, 1k/V (Pulsed), Continuous (5), 10, 20 5, (10), 20

AUTOMATIC SCREENING AUDIOMETRY To insure that pending data is cleared, always begin a new test via the main menu sequence ⌐NEW TEST to clear pending test data. Automatic screening audiometry is a screening exam at selected levels and frequencies automatically conducted by the ES3S. Automatic screening mode is entered by pressing { } (Auto) while in the manual audiometry mode. Automatic screening audiometry presents signals in either an ascending or descending level sequence depending on user selection. For an ascending sequence, the test will begin with lowest level selected and test at each level, up to the highest level selected, or until the patient presses the response button after a presentation. Once the patient responds to a presentation, that presentation level is recorded as the screening result. For a descending sequence, the test begins at the highest level selected and tests at each level down to the lowest level selected. Once the patient does NOT press the button after a signal presentation, the level of the previously presented signal is recorded as the screening result. Figure 5 shows the display format during an automatic screening test. This example indicates that a response has been recorded for a screening level (indicated by the “s”) of 40 dB for 2000 Hz at the Right ear.

Figure 5. Screening Audiometry Display F r e q u e n c y L e v e l E a r

2 0 0 0 4 0 s R i g h t

M a n

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H z d B

Automatic Screening Function Key Pressing { } (Man) during an automatic screening test will exit the automatic screening mode and return to manual audiometry mode. Note that exiting automatic screening mode does not clear the data. Automatic screening mode may be re-entered and continued from the point at which it was interrupted.

Testing Procedure 1) Instruct the patient to press the patient response button whenever a tone is heard. 2) Position headphones over patient’s ears (Red over Right ear, Blue over Left ear). 3) From the manual audiometry screen, press {1} to start the automatic screening test.

Automatic Screening Audiometry Options Frequency Selection Frequencies selected for screening are separate from those selected for manual audiometry. Screening frequencies are selected via the menu sequence: ⌐SETUP ⌐AUDIOMETRY SETUP ⌐AUTO SCREENING ⌐FREQUENCIES. The default frequencies for automatic screening mode are 1000, 2000 and 3000 Hz. Move the highlight to the frequency to select or deselect for testing by using the {◄}, {►}, {▲} and {▼} keys. Once you are at the frequency use the {Ο} key to select or deselect the frequency. Frequencies that are selected have a check mark (√) next to them. Once frequency selection is complete, use the {Menu} key to exit the automatic screening frequency selection mode and return to the menu system. Level Selection The default levels for automatic screening mode are 10, 20, 30 and 40 db HTL. These can be changed via the menu sequence ⌐SETUP ⌐AUDIOMETRY SETUP ⌐AUTO SCREENING ⌐LEVELS. Move the highlight to the level to be selected or deselected using the {◄}, {►}, {▲} or {▼} keys. Once the desired level is selected, use the {Ο} key to select or deselect the level. A (√) next to a level indicates that the level is selected for testing. Once level selection is complete, use the {Menu} key to exit level selection mode and return to the menu system. 17

Sequence Direction The level sequencing direction for automatic screening audiometry is set via the menu sequence ⌐SETUP ⌐AUDIOMETRY SETUP ⌐AUTO SCREENING ⌐ DIRECTION {Up/Down}. Ear to Test First The ear to be tested first during a screening test is selected via the menu sequence ⌐SETUP ⌐AUDIOMETRY SETUP ⌐AUTO SCREENING ⌐ Ear {Left/Right}.

TEST RESULTS Audiometric test results can be displayed on the LCD or transmitted to an attached PC or printer.

Displaying Results on the LCD Test results are displayed via the menu sequence ⌐DISPLAY RESULTS. Threshold levels obtained via manual testing are displayed with an ‘m’, and screening levels obtained via automatic testing are with an ‘s’. Figure 6 shows partial results obtained in automatic screening test mode for the Right ear and results for the Left ear obtained in the manual testing mode. The {◄}, {►}, {▲}, or {▼} keys are used to scroll up or down through the results list.

Figure 6. Audiometric Test Results Display H z 5 0 0 1 0 0 0 2 0 0 0 3 0 0 0 4 0 0 0 6 0 0 0 8 0 0 0

L e f t 2 0 m 2 0 m 2 5 m 3 0 m 2 5 m 2 0 m 2 0 m

R i g h t 2 5 s 2 0 s 2 0 s 2 5 s

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Display Results Key Functions Table 4 lists the valid keys when in the display test results mode.

Table 4. Display Test Results Key Functions {◄}, {►} {▲}, {▼}

Scroll the display screen

{Menu}

Exit display mode and return to the menu system

Quantifying Hearing Loss Table 5 provides a general reference for converting threshold in decibels to degree of hearing loss.

Table 5. Scale of Hearing Loss 0 – 20 dB

Hearing within normal limits

25 – 40 dB

Slight to mild hearing loss

45 – 55 dB

Moderate hearing loss

60 – 70 dB

Moderately severe hearing loss

75 – 90 dB

Severe hearing loss

90 dB+

Profound hearing loss

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SERIAL COMMUNICATIONS The ES3S can transmit data to a computer or to a printer. The default output device is selected using the menu sequence ⌐SETUP ⌐COMMUNICATIONS ⌐DEFAULT OUTPUT, and data is transmitted using the ⌐SEND DATA main menu option. Note that the ES3S implements no handshaking protocol for serial communications. This means that the ES3S cannot detect an unconnected serial port or a ‘not ready’ state. It is the user’s responsibility to verify that a serial cable is connected and that the external device (printer or computer) is powered up and ready for communications before attempting to transmit data. NOTE: While an Earscan 3 is attached to the PC using the supplied USB cable, it is automatically configured for output to a PC at a baud rate of 115.2k, and no setup changes are required.

Transmit Options Table 5 lists optional settings associated with transmitting data.

Table 6. Data Transmit Options Default Output Baud Rate Insert Linefeed

Output data destination Serial port BAUD rate Insert linefeed after after each line (for printer use)

(Printer), Computer (9600), 28.8k, 57.6k, 115.2k No, (Yes)

SCREEN AND CLOCK OPTIONS LCD brightness and contrast are user adjustable to allow optimizing the display for differing viewing conditions (e.g., ambient lighting or viewing angle). The contrast setting has no appreciable effect on battery life, but higher brightness settings require more power and will decrease battery life. The amount of time that the backlight remains on during periods of inactivity is also user settable, and should be set to as low a value as is convenient to preserve battery life. The ES3S includes a real-time clock with rechargeable lithium battery backup to maintain time and date. Time can be set/displayed in either 12- or 24-hour format. Date can be set/displayed in dd/mm/yyyy or mm/dd/yyyy format. The battery is recharged when the ES3 is powered on. When fully charged it should maintain the real-time clock for at least a year, even if the instrument is not used. In the unlikely event that the clock battery should become discharged, the time and date would need to be reset and the instrument left on long enough to recharge the backup battery.

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