<aside> 💡 “We’re just here for a checkup.”
</aside>
Continue.
<aside> 💡 “I have noticed…”
</aside>
Skip through questions to next unanswered question of interest. Try to avoid redundant questions, if possible.
2) Have you had a hearing test before? (1)
<aside> 💡 “Yes.”
</aside>
<aside> 💡 “No.”
</aside>
3) Do you have the results? (1)
<aside> 💡 “I have the results."
</aside>
Keep a copy of these previous results as you test. Use them to check for any differences as you complete today’s testing. Skip to 3b.
<aside> 💡 “I don’t have the results.”
</aside>
3a) What were the results, approximately? (1)
<aside> 💡 “I don’t know."
</aside>
<aside> 💡 “They were _____."
</aside>
Make note of findings and check as you go for changes. Continue.
4) Have you noticed a change in your hearing? (1)
<aside> 💡 “Yes.”
</aside>
<aside> 💡 “No.”
</aside>
5) How has your hearing changed? (1)
<aside> 💡 “It has gotten better.”
</aside>
Review chart to confirm a mechanism for this. If no explanation there, ask:
5a) When did it get better? Did something happen to make it better?
<aside> 💡 “It has gotten worse.”
</aside>
5a) When did it get better? Did something happen to make it better? (1)
<aside> 💡 “When I had medical intervention, it got better.”
</aside>
Check for an improvement with past findings to confirm results. Continue.
<aside> 💡 “It just did one day. I had no medical intervention.”
</aside>
This is odd. Make note of this. Check for an improvement with past findings to confirm results. Continue.
<aside> 💡 “It has gotten worse.”
</aside>
6) Have both ears changed? Do left and right ears hear equally well? (1)
<aside> 💡 “Only one changed. My left/right is better.”
</aside>
STOP. If this is accurate, they need to see an ENT. Continue with case history and testing if they okay it.
<aside> 💡 “Both changed. My left/right is better.”
</aside>
<aside> 💡 “Both changed. They’re about the same.”
</aside>
Make note of this. Skip to 6a.1.
<aside> 💡 “Both changed, and I don’t know.”
</aside>
Make note of this. Continue.
6a) Which ear has better hearing? Has that ear always been better? (1)
<aside> 💡 “Left/Right is better, and yes.”
</aside>
<aside> 💡 “Left/Right is better, and I don’t know.”
</aside>
<aside> 💡 “Left/Right is better, and no.”
</aside>
Make note of this. Ask:
6a.1) Has that always been the case? (1)
<aside> 💡 “Yes.”
</aside>
<aside> 💡 “I don’t know.”
</aside>
<aside> 💡 “No.”
</aside>
Make note of this. Ask:
**6b) When did it change? (1)
<aside> 💡 “After [an incident happened].”
</aside>
STOP. They need to see an ENT/Physician (if they haven’t already) depending on the incident. Make note of this. Continue with case history and testing only if they okay it. Keep on this topic to get more details about the incident, then continue.
<aside> 💡 “Over some time.”
</aside>
<aside> 💡 “I don’t know.”
</aside>
7) Do you have tinnitus or issues with balance or dizziness? (1)
<aside> 💡 “Yes, just tinnitus in both ears.”
</aside>
<aside> 💡 “Yes, just tinnitus in the left/right ear.”
</aside>
Make note of this. Continue.
<aside> 💡
“Yes, _______ and _______.”
</aside>
Make note of this. Ask:
7b) Do they occur together or at different unrelated times?
<aside> 💡 “Yes, just balance.”
</aside>
Make note of this. Could be related to vestibular, ocular, or muscular system. But, we must rule out our systems first. Ask:
<aside> 💡 “Yes, just dizziness/vertigo.”
</aside>
Make note of this. Ask:
**7a) Is it constant or only some of the time? What does it sound like? (1)
7b) Do they occur together or at different unrelated times? (1)
**7c) Does it happen when you do certain things/move in a certain way? (1)
8) History of head injuries or head/neck surgeries? (1)
9) History of ear infections/ear pain and/or drainage? (1)