AWRC AUDIOMETRY & BINAURAL REM/LSM IN ONE SYSTEM Studio Software AWRC Training Manual D-0125128-C DRAFT 1
0123 TÜV SÜD Product Services GmbH Ridlerstraße 65 ◦ 80339 Munich ◦ Germany www.medrx-diagnostics.com 1200 Starkey Rd., #105, Largo, FL 33771 U.S.A. Toll Free: (888) 392-1234 • (727) 584-9600 Fax: (727) 584-9602 • Email: medrx@medrx-diagnostics.com MedRx's Authorized Representative in Europe DGS Diagnostics A/S Audiometer Alle 1 • 5500 Middelfart • Denmark MedRx’s Archived manuals are available at www.medrx-diagnostics.
Contents Getting to Know Your MEDRX AWRC ...................................................... 4 Alternate Speaker Option MEDRX AWRC ................................................. 6 Transducers and Accessories.................................................................... 7 MedRx Charger and Probe Charging ........................................................ 8 Loading Calibration Files...........................................................................
This unit is a Type 1 HFAE audiometer that meets the requirements of both ANSI S3.6 and IEC 60645-1 and IEC 60645-2. These standards specify the required precision that the MedRx AWRCMEDRX AWRC does achieve. Measurement uncertainty is +/- 1 dB. This device and transducers are intended for use at test frequencies between 125 Hz and 16000 Hz. This unit meets the requirements of both ANSI S3.46 and IEC 61669. These standards specify the required precision that the MedRx AWRC MEDRX AWRC does achieve.
MedRx AWRC Audiometer Intended Use Statement: MedRx AWRC REM Intended Use Statement: The MedRx Audiometer is intended to be used for the purposes of determining patient hearing sensitivity. It is intended to quantify the patient's level of hearing by presenting pure tone stimuli through specific transducers at different frequencies and at different sound pressure levels.
Alternate Speaker Option MEDRX AWRC Notice! The Red & Blue adapters are included and must be removed to attach 18 gage (1.0mm) Free Field speaker wires and then reinstalled. To Install Free Field Speaker Wires: Screw Driver Screw Driver Unplug both the Red & Blue connectors. Place a small flat head screw driver on the small orange tabs and push down while inserting a speaker wire into the opening then remove the screw driver. Be sure the wire is secure.
Transducers and Accessories Make sure that the correct transducers are set in the software by right clicking any transducer button on the audiometry screen and left-clicking to change the transducer. Use the accessories provided with your MEDRX AWRC. Use of unapproved accessories is not recommended.
MedRx Charger and Probe Charging The MedRx Charger is designed to charge the MedRx AWRC REM Probes though Qi charging. The MedRx Charger comes with a USB cable and wall adapter for power. The LED lights in the MedRx Charger are designed to display the charge level of the internal battery and the AWRC REM Probe batteries. MedRx AWRC probes can be inserted into either side of the charger.
Loading Calibration Files Each MedRx Audiometer is calibrated in compliance with the ANSI S3.6 standard. This calibration procedure results in a series of files that the Audiometer software reads to keep the hardware in calibration. These files are supplied on a USB Stick. The final step before using your MedRx Audiometer to evaluate hearing is to load these device specific calibration files onto the computer used to operate the Audiometer device. 1.
AUDIOMETER MODULE Studio Software Overview The MedRx Studio software can run stand-alone or from Noah System or the TIMS Noah-Compatible Office System. Launching the MedRx Studio Software Basic Software Options Several options are available which allow the user to customize the MedRx Studio Software to meet their needs. Access these options by clicking the settings wheel in the top right menu bar. Stand Alone • Double click the MedRx Studio shortcut on your Windows Desktop. Noah • • • Launch Noah.
Audiometry Select AUD from the main menu. Top Tool Bar The Tool Bar icons have the following functions: The Main Screen settings allows you to set the default modules, database, print templates and more. If you have more than one MedRx product you can show/hide modules in the Main Screen settings. NOTE: Remember, more information is always available in the Interactive Help System by clicking the “?” Icon in the top right corner of the software or pressing the F1 key. 1. 2. 3. 4. 5. 6. 7. 8. 9.
Configuring the AUD Software It is important to note that each module will have different settings available for customization. Assign Transducers Option 1: On the General Options screen click Outputs to assign specific transducers to the audiometer outputs. Enter the module and click the settings wheel to customize. Option 2: You can change transducers by Right-Clicking on any transducer icon on the Audiometry screen. The Audiometry module has unique settings for the module.
Preparing for Testing Use the accessories provided with your MedRx Audiometer. Typical acceptable transducers are shown on page 6. Operator headsets for use with the MedRx Audiometer should have 32 ohms impedance and the speaker power should be at least 50 watts. Air conduction transducers for use with this device should have an impedance of 10 ohms. The speaker voltage should match the local mains voltage where the device is used.
Supra-Aural Headphones Placing the Bone Conductor 1. Locate the mastoid process behind the pinna. This is the bony shelf just behind where the ear meets the head. 2. Carefully place the bone conductor on the mastoid process and hold it in place. 1. Place the headphones on the patient’s head so the center of the headphone is directly over the opening of the ear canal. 2. Adjust the headband so the headphones remain in place, but be careful not to make it so tight as to cause patient discomfort.
Sound Field Testing The Sound Field speakers (Free Field) should be connected using optional or user supplied amplifier and speakers. They should be calibrated annually as per ISO 8253-2, located at least 1 meter from the patient ear and at the same height. To Install Free Field Speaker Wires: Notice! The Red & Blue adapters are included and must be removed to attach 18 gage (1.0mm) Free Field speaker wires and then reinstalled.
Performing Audiometric Testing The screen shot below shows the controls which are available from the Audiometer main window. The sections of the manual that follow explain how to use these tools to perform hearing evaluations using your Audiometer. 1. Test Selection Tool Bar 2. Settings Selection Bar 3. Ear Selection 4. Output Selector 5. Test Type Selector 6. Tone Type Selectors 7. Display Options (Frequency) 8. Test and Masking Interrupter, Routing Selector 9. Output Level Potentiometers 10.
Pure Tone Audiometry Pure Tone Audiometry measures the patient’s peripheral hearing sensitivity, or the softest levels they can hear pure tones at a variety of frequencies. These thresholds are plotted on a standard graph called an audiogram. The MedRx Studio software controls the hardware, stores the data (if running within Noah or TIMS) and prints a standard or custom audiogram report. Pure tone Audiometry can be performed via earphones or a Bone Conductor (Bone Conduction).
Pure Tone Audiometry via the Bone Conductor 1. Following the instructions on page Error! Bookmark not defined. (Need to add the appropriate markup), place the Bone Conductor on the mastoid process behind the ear with better air conduction thresholds as measured above. If the thresholds are equal, place the Bone Conductor on the mastoid process behind the right ear. 2. Establish bone conduction thresholds as described above (see page Error! Bookmark not defined.
Speech Reception Threshold (SRT) 5. Use your mouse to select the new masking type and routing for your specific application. 6. When you are finished making changes to the Masking, click X. Speech Audiometry Speech audiometry evaluates how well the patient can hear and understand speech. The typical test battery includes tests of speech threshold and tests of speech discrimination.
5. Click the Play button or press the F9 key to present a word. The word will play through the chosen transducer as well as display on the screen. 6. If the patient correctly repeats the word, click the Correct button or press F7. 7. If the patient incorrectly repeats the word, click the Incorrect button or press F8. NOTE: F7 and F8 auto advance the playlist to the next word but will not play the next word. F9 plays the highlighted word. F10 advances to the next word and plays it.
6. To Input & Calibrate the Rainbow Passage in WR for MCL: c. The Rainbow Passage is now part of the MedRx Studio Audio Files for future use. a. Press the small file folder on the top right of media player. Then select “Browse” in the speech material. d. Use the drop down in the media player and select track 10 – Calibration (1000Hz). e. Click play or start signal. b. Select Rainbow Passage by double clicking twice. f. Then click the calibration arrow next to the UV meter. g.
i. Click on the channel icon just below and to the right of the VU to switch channels. j. Repeat steps d - f for the remaining channel. Note: This calibration also needs to be done with any custom word list. 8. When using the Mic option adjust your input using the slider so that it is peaking at the black triangle under the VU meter. The VU meter is just below the Test button in MedRx Studio and will become active once you press Test. 7.
Word Recognition (WR) Word Recognition (WR) is a discrimination, or recognition type test using speech as the stimulus. WR testing measures the percentage of mono-syllable words repeated correctly from a phonetically balanced list. Unlike the SRT test, the WR test is performed at a fixed intensity (dB) level. Typical patients will score their best on WR testing at a level between 35 and 40 dB above their SRT. 2. Click the WR button located on the toolbar on the top of the screen. 3.
QuickSIN The primary complaint of hearing-impaired persons is difficulty hearing in background noise. The measurement of SNR loss (signal-to-noise ratio loss) is important because speech understanding in noise cannot be reliably predicted from the pure tone audiogram (Killion & Niquette, 2000). The QuickSIN test was developed to: 1. Provide a one-minute estimate of SNR loss. 2. Provide a quick way for clinicians to quantify a patient’s ability to hear in noise. 3.
Performing the QuickSIN Test 2. Play the first sentence in the list by clicking the Play button. Ask the patient to repeat the sentence. 1. From the MedRx Studio main screen, Click the AUD button. 2. Click the QuickSIN button located on the toolbar on the top of the screen. Present the test with earphones or in a sound field. The attenuator dial is set to 70 dB HL. For subjects with PTA hearing losses greater than 45 dB HL, the attenuator dial is set to a level that is “loud but OK.
VRA MODULE (Optional) The VRA module is a Visual Reinforced Audiometry (VRA) module available in the MedRx Studio software. This is an optional module which must be licensed to activate. Contact your MedRx representative if you have questions regarding activation. Visual Reinforced Audiometry is a test designed for pediatrics when the child is too young for normal pure tone testing. This test is typically performed with children 6 months to 2-3 years of age.
Force Software Rendering should always be set to Yes to prevent delays in video presentation. Reset Screens will discard the selected screen set up. Reset Screens will discard the selected screen set up. Select 3 for Number of Presentation Screens. This will allow for three monitors to be used with the VRA Studio module. Three Screen Setup Two Screen Setup Select 2 for Number of Presentation Screens. This will allow for two monitors to be used with the VRA Studio module.
VRA Test Settings Reward Video Setup In the Reward Video Setup, custom videos can be added and the order of video rewards can be edited. To add a new video, select the plus next to Add New Video. Note that the Stimulus Length, Response Window, Non-Stimulus Rate, Reward Length, and Rewards Randomized are greyed out. These are to be adjusted within the iVRA App. Default Output, Default Signal, Default Pulse Type, dB Weighting, can be selected in this section.
Connecting MedRx Studio and iVRA App To connect MedRx Studio and the iVRA app you will need to connect to the same wireless network. This can be a local network or a network with internet access. Once you have connected the devices to the same network, you will need to determine the IP address of the PC. To do so: In Studio VRA Settings, Click Identify IP Address: Enter the Computer Name or IP Address found in the Studio settings.
VRA Settings Non-stim rate How often are catch trials inserted The transducer selection is performed in MedRx Studio software prior to beginning the VRA test. All transducers are inherited through the AUD module. If you do not see a transducer you would like to use then you will need change the preferences in the AUD module.
iVRA Conditioning Mode The iVRA conditioning is initiated through the iOS app. The iOS app and MedRx Studio must be connected for the testing to begin. Once the iOS app and MedRx Studio are connected, navigate to the conditioning tab. The reward screens will turn black when the Start Conditioning button is clicked. Once the conditioning has begun, the iOS app will look like the left image. You may select presentation ear, frequency, level, and video reward.
iVRA Manual Test Mode The iVRA manual test mode is initiated through the iOS app. The iOS app and MedRx Studio must be connected for the testing to begin. Once the iOS app and MedRx Studio are connected, navigate to the Tests tab. To begin manual testing, click the Manual button in the Test tab. When you click the Manual button, the reward screens will go to black and the testing will be ready. Once the manual test mode has begun, the iOS app will look like the left image.
iVRA Automatic Test Mode To begin automatic testing, click the Automatic button in the Test tab. When you click the Automatic button, the reward screens will go to black and the testing will be ready. Once the automatic test mode has begun, the iOS app will look like the left image. You may select presentation ear, frequency, starting level, and video reward. Note: You have the option in the Studio settings to fix presentation ear to binaural during free field testing.
If there is a centering screen, double tap the presentation level to present a video reward on the center screen. Be sure to click Send in the top right of the iOS app when testing is complete. To exit the automatic test mode you can hit Quit in the iOS app. Be sure that your test results are saved prior to exiting. If you would like to exit the Automatic Test Mode from the PC, press the Shift + ESC key. VRA MedRx Studio Logging Logging of test sessions are available through MedRx Studio.
Tinnometer MODULE (Optional) Performing the Tinnometer Testing Purpose of the Tinnometer Tinnitus is experienced by millions of people worldwide. The Tinnometer is designed to mimic the sounds of tinnitus in order to provide an accurate and flexible tinnitus assessment. Tinnitus assessment increases patient rapport with the clinician when an equivalent tinnitus sound can be created. The Tinnometer can accurately create tinnitus sounds for fast and reliable tinnitus assessment.
Key features of the Tinnometer Main Screen: 1. 2. 3. 4. 5. 6. 7. Toggle Switch to Start/Stop stimulus Sliders to control frequency, bandwidth, slope and tempo of the stimulus Slider to control the intensity of the stimulus Buttons used in determining tinnitus match, threshold and minimum masking level Area where description of items will be displayed Channels designed to present multiple types of tinnitus sound A graphical display of the sounds being played for the patient.
Interactions with the Patient are Controlled as Follows: 1. 2. 3. 4. 5. 6. Patient Response Switch Indicator Patient Monitor Microphone Talk Forward Undo Toggle Help Section Return to Studio There are 3 Steps Needed for Tinnitus Assessment with the Tinnometer Step 1: Identify Patient’s Tinnitus 1. Start by selecting the tinnitus type that has been described by the patient. This is an approximation of the tinnitus sound your patient hears.
Step 2: Find Identified Tinnitus Threshold 3. Use frequency slider to match the pitch of the patient’s perceived tinnitus. 4. Use volume slider to match patient’s perceived intensity of tinnitus. 5. Adjust bandwidth, slope and tempo (for pulsating tinnitus or prevention of adaptation) as needed. 6. Buttons to allow greater flexibility in bandwidth and slope of tinnitus. Allows the addition of high/low frequency sounds independently. 7. Allows for independent right/left volume control. 8.
Tinnometer Modulation Tab The Tinnometer modulation tab is designed to simulate sound generators when hearing aid demonstrations cannot be performed. The following are controls used in Modulation. 1. 2. 3. 4. 2. Enter the modulation tab on the right side of Tinnometer software. Type of Modulation Sound Speed of Modulation Frequency of Modulation Modulation Volume Range To use the Modulation features within Tinnometer, you must first complete the three steps involved with tinnitus assessment.
Tinnometer Audiometry Scan The Tinnometer Scan tab is designed for various forms of air conduction audiometry. There are three types of audiometry that can be performed with Tinnometer. You can access the forms of audiometry with the buttons located in the image to the left. A complete tinnitus assessment must be performed prior to performing testing in the RI tab. Once tinnitus assessment testing is completed, optional residual inhibition testing can be performed with the following steps: 1.
4. Click the stop watch to begin the masking stimulus (stimulus to play for 60 seconds). Tinnometer Report Printing The Tinnometer has four reports available for printing: • • • • Tinnitus Assessment Report. Manufacturer Guidance Report. Questionnaire Report. Channel Report. The following are common features found across reports: 1. To generate your report, select “printer …” from the File menu. 5. Stimulus will play for 60 seconds and automatically stop at the 60 second point. 2.
Tinnitus Assessment Report Tinnitus assessment reports are able to be generated after completing the three steps to tinnitus assessment. Once all steps are complete you are able to print a report 3. Use the drop down box to select a diagnosis for the patient. 1. To generate your tinnitus assessment report, select “printer …” from the File menu. 2. The “Channel” reports are the tinnitus assessment reports. Select the channel used for testing or All Channels when multi-channel testing is completed. 4.
Manufacturer Guidance Report Manufacturer guidance reports are designed to provide hearing aid sound therapy guidance to a clinician based on tinnitus assessment results. Sound therapy is an option to tinnitus treatment. We encourage all clinics to develop a tinnitus treatment protocol that is in line with their tinnitus treatment goals. Manufacturer guidance generated by the Tinnometer is designed to be a starting point in sound therapy and each patient may differ in preferred sound. 3.
Graph Channel Report Questionnaire Report Graph channel reports will print a patient report which displays an image of the patient’s tinnitus with QR codes for YouTube videos that play a wind modulation noise nearest to their tinnitus. To generate the report you must: Questionnaire reports will only show as an option once the questionnaire has been completed. Once a questionnaire has been completed and you are ready to print a report you must: 1.
REM / LSM MODULE Studio Software Overview The MedRx Studio software can run stand-alone, from Noah System or the TIMS Noah-Compatible Office System. Launching the MedRx Studio Software Basic Software Options Several options are available which allow the user to customize the MedRx Studio Software to meet their needs. Access these options by clicking the settings wheel in the top right menu bar. Stand Alone • Double click the MedRx Studio shortcut on your Windows Desktop. Noah • • • Launch Noah.
Pairing AWRC REM Probes New AWRC devices will have the REM Probes pre-paired with the main unit. There will be no need to manually pair probes. Manually Pair Replacement AWRC Probes To pair replacement AWRC REM probes 1. Open Studio and Enter the REM or LSM module The Main Screen settings allows you to set the default modules, database, print templates and more. The Probe Indicator should show ? in the battery which indicates the software is searching for AWRC Probes 2.
AWRC REM Probe Connections NOTE: The AWRC REM Probe will only connect while MedRx Studio is in either the REM or LSM Module. Live Speech Mapping Select LSM from the main menu. To connect AWRC REM probes to the baseboard 1. Open Studio and Enter the REM or LSM module Top Tool Bar The Tool Bar icons have the following functions: The Probe Indicator should show ? in the battery which indicates the software is searching for AWRC Probes 2. Power on the AWRC REM Probes.
Bottom Tool Bar The Bottom Tool Bar icons have the following functions: ___________________________________________________________________________ The Wrench icon displays options for: 1. Ear Selection 2. Stimulus Selection 3. Viewing Mode 4. Open Fit Function 5. Reset Averages 6. Probe Connection 7. Start & Stop buttons The Target Selection icon sets up: 1. Target type 2. Client information 3. Hearing aid parameters The Display icon sets up which target lines to display on the measurement screen.
General LSM Options The Fitting tab sets the default fitting rule, client information, output and hearing aid parameters. Click the settings wheel in the top right menu bar. The LSM tab sets your default view and default target levels. The General tab defines the default appearance of the Live Speech Mapping test environment. The Fitting tab also sets default NAL or DSL default settings.
The Signal tab sets the signals displayed on the Live Speech Mapping Screen. The REUR tab sets the view options. The REOR tab sets the view options. The Shown Tests tab sets the tests displayed in the Live Speech Mapping module. The Percentiles tab sets the view options.
Preparing for Testing Positioning the Speakers Proper positioning of the loudspeakers relative to the patient’s hearing aids is critical for making accurate and repeatable measurements. Seat the patient so their ear is between 19 and 39 inches from the loudspeaker. The speaker is designed to sit at desk height. When using Live Speech inputs, position the patient and loudspeaker as shown below.
Probe Tube Calibration For reasons of infection control and reliability of results, MedRx recommends that a new probe tube be used with each patient. To ensure accurate measurements, it is necessary to calibrate the probe tube each time it is replaced. 1. Place a new probe tube on the probe microphone port as shown. 2. Place the probe tube between the calibration nibs as shown. Be sure that the opening of the probe tube is centered on the opening of the reference microphone.
Step-by-Step Guide to Live Speech Mapping Ensure that the Audiogram is entered Before making Live Speech Mapping measurements, the patient’s pure tone audiogram must be available to the software. This can occur several ways: 1. The audiogram was automatically entered by MedRx Studio software when testing. 2. The audiogram was manually entered into the Noah audiogram module or Noah 4 software and saved. 3. The audiogram was entered using another manufacturer’s audiogram module.
Speech Mapping with Recorded Inputs It is also possible to use an audio CD, such as the patient’s favorite music to perform Speech Mapping. Select CD as an option under General and Signal. The Studio software provides several digital audio files to use as a repeatable stimulus for Speech Mapping. These are accessed by clicking the File button on the right and then selecting the desired track from the pull-down menu in the audio player. Peak measurements are recommended.
The screen shot below provides an overview of all the tools and controls on the Live Speech Mapping screen. For more information on these features, please consult the Interactive Help system by pressing the F1 key or clicking the Help icon. 1. 2. 3. 4. 5. 6. 7. 8. 9. Sound Level Meter Settings Selection Bar Ear Selection Test Stimulus Measurement Type • Peaks • LTAS Open Fit Function Reset Button Probe Connection Status Start and Stop Buttons 10. Tools Tab, Target Selection Tab, and Display Tab 11.
Running Speech Mapping “On-Top” MedRx Live Speech Mapping Protocol The MedRx Studio system is tightly integrated with Noah, the industry standard for audiometric and fitting data storage and retrieval. The On-Top mode of the LSM software allows you to effortlessly alternate between measurement and fitting adjustments. Unlike other products, the AVANT REM+ system places full control over the measurement environment firmly in the hands of the hearing care professional.
a. Using your audiometer, measure and record the following values: b. Pure Tone Air and Bone conduction thresholds. c. Narrow Band Noise or Pure Tone UCL at 500, 1000, 2000 and 4000 Hz. d. Other tests if needed in your practice or jurisdiction. 3. Position patient as described earlier in this manual on page 68 (Update). 4. Calibrate Probe Tube as described earlier in this manual on page 48 (Update). 7. Carefully place the hearing instrument in the ear without disturbing the probe tube. 8.
Real Ear Measurement Settings The screen shot below provides an overview of all the tools and controls on the REM screen. For more information on these features, please consult the Interactive Help system by pressing the F1 key or clicking the Help icon. tab at the top of the screen, and selection Help Topics. Select an item from the list in the Index tab, and click Display. MedRx Real Ear Measures Protocol 1. Complete a careful otoscopic examination as instructed by the manufacturer of your otoscope. a.
4. Calibrate Probe Tube as described earlier in this manual on page 48 (Update). 5. Measure and place the probe tube in the ear canal. (Use chart to the left). 6. Complete a Real Ear Measurements UNAIDED (RUER). a. ISTS or file input b. Peak Measures c. 1/3 Octave resolution 7. Complete a Real Ear Measurement AIDED (REAG) 8. Using the On-Top mode, make any adjustments needed to the hearing instrument so that: a.
the density of frequencies (individual cycles) raises with frequency, there is more energy in high octaves. required by the hearing aid to reach targets, but may result in underfitting at high frequencies. White-weighted noise can be used mostly for testing of equipment. It is not recommended to use it for hearing aid fitting, unless specified by the manufacturer. Crest Factor: BBN = 4.46 (13.0dB), PRN = 5.17 (14.3dB) Crest Factor: BBN = 1.73 (4.8dB), PRN = 7.86 (17.
The REAG is simply the REAR expressed as gain rather than SPL. Selecting REAG allows you to see the gain at each frequency for each of the REAR curves measured. REOR measures the effect on the natural external ear effects resulting from inserting an ear mold or a hearing instrument, before it is turned on, into the ear canal. The REOR is also referred to as Insertion Loss. REOR is also useful for validating the effectiveness of venting or canal length changes to the mold.
measures, the “real ear” factors are incorporated into the results. The resulting simulated measurements provide information to select and make adjustments to the hearing instrument and verify adjustments in the MedRx coupler rather than in the uncooperative client’s ear. This is particularly important in the case of children, whose small volume ear canals enhance high frequency amplification more so than in average adults.
Coupler Response When the REAR measurement is complete, you are prompted to perform a coupler response. • • • Attach the hearing instrument or the insert headphone (must be the same as in the REAR test) to the appropriate coupler and place the probe tube inside the coupler. • If a hearing instrument is used, be sure to perform this measurement at the same volume control setting as the first measurement. • Select START to open the measurement type selection screen.
If a more specific frequency analysis of the feedback is desired, change the resolution of the system to 1/24 octave and adjust the smoothing in the General LSM or REM settings menu. This image shows the similar feedback as above at 1/24 octave, smoothing 1. Using this information, make any necessary adjustments to the hearing instrument to reduce or remove the feedback. Hearing Loss Simulator The Hearing Loss Simulator demonstrates the effect of the client’s hearing loss for the significant third party.
RP is applied by default. A new rule can be selected from the list on the right side of the display. A volume adjustment bar allows for manual adjustment of the output level. The control panel on the right of the display provides options for input signal source and the task icons for Normal and Simulate. The Master Hearing Aid applies gain separately for each ear. If audiogram values are entered for the left and right ear, the selected fitting rules will be applied to each ear separately.
PRINTING Printing within the MedRx Studio software. You can use the templates provided at installation or create your own templates to suit your needs. Icons in the Print Window To Use an Existing Print Template 1. Click the print icon in the top tool bar or hold down the Ctrl key and click the P key on your keyboard. 2. Select the template you would like to use. 3. Click the print preview icon to see the patient’s data & images on the template before printing. 4. Click the print icon. 1. 2. 3. 4. 5. 6.
Create New Print Templates 8. Drag and drop elements onto the page to create your template. a. You can combine data from multiple modules into a single template. b. Elements may overlap and will stack/cover previously added elements. c. Certain elements will have settings that can be adjusted after dropping onto the page. d. You can resize all elements. The contents of each element will resize within the box depending on the amount of data in the element. 1. Select the printer icon. 2.
Rainbow Passage When the sunlight strikes raindrops in the air, they act like a prism and form a rainbow. The rainbow is a division of white light into many beautiful colors. These take the shape of a long round arch, with its path high above and its two ends apparently beyond the horizon. There is, according to legend, a boiling pot of gold at one end. People look, but no one ever finds it.
EMC Precautions MedRx AWRC should be operated only in a professional healthcare facility by trained professionals with education and/or training in the field of audiometry. Further the equipment can’t be used in a residential environment. The EMISSIONS characteristics of this equipment make it suitable for use in industrial areas and hospitals. If it is used in a residential environment this equipment might not offer adequate protection to radio-frequency communication services.
Warnings! • • • • • The use of accessories, transducers and cables other than those specified, with the exception of transducers and cables sold by the manufacturer of the MedRx AWRC as replacement parts for internal components, may result in increased emissions or decreased immunity of the MedRx AWRC.
Guidance and manufacturer’s declaration – electromagnetic emissions Guidance and manufacturer’s declaration – electromagnetic immunity The MedRx AWRC is intended for use in electromagnetic environment specific below. The customer or the user of the MedRx AWRC should assure that it is used in such an environment. The MedRx AWRC is intended for use in electromagnetic environment specific below. The customer or the user of the MedRx AWRC should assure that it is used in such an environment.
Guidance and manufacturer’s declaration – electromagnetic immunity The MedRx AWRC is intended for use in electromagnetic environment specific below. The customer or the user of the MedRx AWRC should assure that it is used in such an environment.
MedRx AWRC Baseboard and MedRx Wireless REM Probe ISED non-interference disclaimer This device contains license-exempt transmitter(s)/receiver(s) that comply with Innovation, Science and Economic Development Canada’s license-exempt RSS(s). Operation is subject to the following two conditions: (1) This device may not cause interference. (2) This device must accept any interference, including interference that may cause undesired operation of the device.
MedRx AWRC Baseboard and MedRx Wireless REM Probe FCC compliance statement This equipment has been tested and found to comply with the limits for a Class B digital device, pursuant to part 15 of the FCC Rules. These limits are designed to provide reasonable protection against harmful interference in a residential installation.
Safety • Regarding electrical safety, this device is designed to be used only by professionals in the hearing healthcare industry. • It is Class II Medical Electrical (ME) equipment that is part of an ME system. This device provides Type B protection (Type B equipment, Type B applied part) • This device is not protected from ingress of water. Power is supplied by an ungrounded mains power cable to a medical grade power supply and also supplied by the USB cable connected to a computer.
Symbols that may be used or SN Read the instruction manuals for safe usage of the device (operating instructions) Indicates that the device serial number will follow Type B applied part.
Recommended Procedures for Cleaning and Disinfection 1. Foam ear tips and probe tubes are single use components, and should not be re-used by another patient. 2. It is recommended that 70% Isopropyl Alcohol should be applied to a soft clean cloth or tissue, not directly on the component to be cleaned. The cloth should never be wet, just damp. A mild soapy water solution is an alternative cleaning liquid. 3.
Permissions (Optional) MedRx Studio uses the default windows user accounts to control access to the software. The default user settings are typically sufficient for regulatory bodies. These settings can be also adjusted if needed to comply with country requirements. MedRx Studio software does not store private information. Data control is performed by the office management system or patient management system (i.e. Noah, Blueprint, Sycle).
Adjusting log out time period Create user settings to lock the computer when not in use. Navigate to local security policy and adjust the Amount of idle time required before suspending session. Adjusting this setting will prevent unintended access to the computer and health records. Setting maximum password age Local Security Policy will also identify the required password expiration timeframe. Be sure to set this to local standards.
Technical Information The MedRx AWRC Audiometer/REM Combination is an active, diagnostic Class IIa Medical Device according to the EU Medical Device Regulation 2017/745. Standards: IEC 60601-1: Class II IEC 60601-1-2: Class A IEC 60645-1 IEC 61669 ANSI S3.6: Type 1 HFAE ANSI 3.
Calibration values and Max Levels: Headphone DD45 NBS-9A acoustic coupler Force 4-5 N, ANSI and IEC DD45 RETSPL Values RETSPL dB re 20μPa 125=47.5 250=27.0 500=13.0 750=6.5 1000=6.0 1500=8.0 2000=8.0 3000=8.0 4000=9.0 6000=20.5 8000=12.0 Speech=18.5 Calibration values and Max Levels: Headphone TDH39 NBS-9A acoustic coupler Force 4-5 N, ANSI and IEC RETSPL dB re 20μPa 125=45.0 250=25.5 500=11.5 750=8.0 1000=7.0 1500=6.5 2000=9.0 3000=10.0 4000=9.5 6000=15.5 8000=13.0 9000=13.0 10000=13.0 11200=13.
Maximum Sound Levels: Frequency Inserts Supra-aural Sound Field 125 75 80 65 Bone Conduction 250 100 100 80 45 500 110 110 90 60 750 110 110 90 60 1000 115 120 90 70 1500 115 120 90 70 2000 115 120 90 70 3000 115 120 90 70 4000 115 120 90 60 6000 100 105 90 50 8000 90 100 80 45 Routine checking and subjective tests The user of the instrument should perform a subjective instrument check once a week.
Limited Warranty MedRx, Inc warrants this product to be free from defects in material and workmanship for one year from the time of purchase. If this system fails to perform as specified during this period, the purchaser is responsible for calling MedRx at (888) 392-1234 or (727) 584-9600. The company's representative will advise the owner to either return specific components or the entire system to: MedRx, Inc.
