Recommendations on Performing Newborn Hearing Screening and Confirmatory Tests during the COVID-19 Pandemic

Follow your hospital’s or institution’s procedural protocols regarding disinfection and attire during the COVID-19 pandemic. However, the following are the NHSRC recommendations to ensure the safety of the patient and personnel while performing hearing tests in infants.

RECOMMENDATIONS ON TESTING:

Performing hearing tests in infants are considered non-invasive and non-aerosol producing procedures.  However, because of the COVID-19 pandemic certain precautions will need to be in place to protect the patients, medical and paramedical staff when performing hearing tests on infants.

1. Timing:

1. Newborn hearing screening should be performed when the baby is healthy and ready for discharge for hearing screening using Otoacoustic Emissions (OAE) or Automated Auditory Brainstem Response (AABR). The timing for newborn hearing screening can be maximized to three (3) months, after which confirmatory testing using Auditory Brainstem Response (ABR) with or without Auditory Steady State Response (ASSR) is advised for those who will have a REFER result.  However, it must be noted that for Philhealth claims, hearing testing should be done within 2 months or 60 days.

1. For infants born to mothers who are SUSPECTS or COVID-19 positive, testing should be done after the infant becomes COVID-19 negative or before 3 months after birth preferably using Automated Auditory Brainstem Response (AABR) so that no retest will be done if the result is REFER, immediately proceeding to confirmatory testing when needed as previously mentioned. Testing using OAE or AABR can be also be done shortly before discharge provided extra precaution should be employed (see preparation).

2. Preparation:

• Social distancing of at least 2 meters or 6 feet must be maintained in the waiting area.
• The parent, guardian or assistant holding the infant must wear a mask.
• PPEs for personnel performing screening or confirmatory testing on infants are the following: surgical cap, surgical mask, eye protection in the form of goggles or face shield, disposable gloves on both hands, gown and booties.

Extra precaution while doing newborn hearing screening should be employed for infants of unknown COVID-19 status born to SUSPECT or COVID-19 positive mothers by using a transparent hood, tent or incubator while doing hearing testing.   The infant is placed inside the transparent hood, tent or incubator.  Similarly, collection booths protecting the screener used in specimen collection for COVID-19 testing can also be used.

Confirmatory testing should not be done on infants without knowing the COVID-19 status.  Only COVID-19 negative infants should undergo confirmatory testing using ABR and ASSR.

3. Testing:

• Make sure the device, whether hearing screening or confirmatory test, is disinfected before testing and that new ear tips and electrodes are applied as specified in the manual.
• Wash hands with soap and water and apply 70% alcohol or similar antiseptic. Wear a new pair of gloves.
• Perform hearing screening or testing.
• Discard disposable components after testing.
• Discard pair of gloves. Wash hands with soap and water and apply 70% alcohol or similar antiseptic after testing.
• Fill-out registry card, update database, and give advice to the parent or guardian.

NEWBORN HEARING SCREENING REGISTRY CARDS:

The distribution of Newborn Hearing Screening Registry Cards shall resume when the Luzonwide lockdown is lifted.  We are expecting significant delays in delivery especially to facilities outside of Metro Manila.  The current limit is 120% of the number of births during 2019 or if the facility is new 300 sets.  Kindly email Ms. Marian Conopio at  registrycards.nhsrc@gmail.com or text at +63 9958679002.

CERTIFYING COURSES:

Newborn Hearing Screening Personnel Certifying Courses shall resume when the Luzonwide lockdown is lifted.  The earliest would be on June 14, 2020 at Our Lady of Lourdes Hospital in Manila.   Likewise, we are in the process of converting the course to an online format with an appointment system to Category B, C and D Centers for the written and practical examinations.  Kindly email Ms. Nicka Fria for inquiries at certifyingcourse.nhsrc@gmail.com or text at +63 995 558 8842.