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:
   A. 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.
   B. 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:
   A. Social distancing of at least 2 meters or 6 feet must be maintained in the waiting area.
   B. The parent, guardian or assistant holding the infant must wear a mask.
   C. 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, and gown.
   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:
   A. 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.
   B. Wash hands with soap and water and apply 70% alcohol or similar antiseptic. Wear a new pair of gloves.
   C. Perform hearing screening or testing.
   D. Discard disposable components after testing.
   E. Discard pair of gloves. Wash hands with soap and water and apply 70% alcohol or similar
   antiseptic after testing.
   F. Fill-out registry card, update database, and give advice to the parent or guardian.
   NEWBORN HEARING SCREENING REGISTRY CARDS:
   During ECQ, distribution of Registry Cards shall continue. However, WALK-IN TRANSACTIONS shall not be entertained. We shall only accept ONLINE TRANSACTIONS.
   • Placing orders, inquiries and concerns shall be coordinated online via email, call or text.
   • Payments for Registry Cards, courier fee shall be paid through bank or online payment only.
   • Registry Cards shall be sent out via courier only. Pick-ups shall not be allowed.
   • Documents needing physical signature shall be shipped to NHSRC which shall then be shipped
   back to the customer.
   The current limit is 120% of the number of births during 2020 or if the facility is new 300 sets. For orders,
   concerns and inquiries, kindly coordinate with Ms. Marian Conopio through email at registrycards.nhsrc@gmail.com or call/text at 0995 867 9002.
   CERTIFYING COURSES:
   The Personnel Hearing Screening Certifying Courses were converted into online format and is held monthly. Php 2,000.00 for the new participants and Php 500.00 for recertification. For schedule, registration concerns and inquiries, kindly coordinate with Ms. Nicka