Amplivox CA 850-2 Manual

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-1-

CONTENTS PAGE

(1) Introduction .. .. .. .. .. .. 3

(2) Unpacking Instructions .. .. .. .. 3

(3) Front Panel Layout .. .. .. .. .. 4

(4) Front Panel Keys .. .. .. .. .. 5

(5) Back Panel Layout .. .. .. .. .. 7

(6) Audiometry Preparation .. .. .. .. 8

(7) Audiometer Connections .. .. .. .. 9

(8) Operating the CA850 Series 2 .. .. .. 10


1. Switching on
2. Operating Schematic
3. Standby mode
4. Selection of Test Mode

(9) Manual Test Mode .. .. .. .. .. 13

(10) Bekesy Test Mode .. .. .. .. .. 20

(11) Computer Test Mode .. .. .. .. 28

(12) Database Functions .. .. .. .. .. 35

(13) Audiometric Test Options .. .. .. .. 40

(14) Technical Specification .. .. .. .. 46

(15) Connectors .. .. .. .. .. .. 47

(16) Physical Parameters .. .. .. .. 47

Appendix A - Hearing Categorisation Function .. .. 48

Appendix B - RS232 Specification .. .. .. 51

Appendix C - Warranty .. .. .. .. .. 55

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1. INTRODUCTION

Thank you for purchasing the CA850 Series 2 digital audiometer. The CA850
is an automatic audiometer that incorporates a number of innovative features
which make it the ideal instrument for use in today's health care environment.

This operator's manual is formulated to enable you to take full advantage of


these innovative features offered by the CA850. Therefore, please read
thoroughly.

2. UNPACKING INSTRUCTIONS

On receiving your audiometer carefully remove the equipment from the


shipping box. This box is designed to ensure that the audiometer is protected
during transit. Therefore, please RETAIN THIS BOX for use when returning
the audiometer for after sales support functions, for example instrument
calibration.

Check that all the equipment listed below has been delivered:

(1) CA850 Series 2 Digital Audiometer


(2) Keyboard
(3) Headset with noise reducing headset enclosures
(4) Patient response button
(5) Audiogram paper
(6) Mains lead
(7) Quick reference guide

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3. FRONT PANEL LAYOUT

1. AUDIOMETER PAPER ENTRY SLOT 12. YES/RUN KEY


2. PRINTER COVER 13. NO/STOP KEY
3. PRINTER COVER RETAINING SCREWS 14. TALK OVER VOLUME CONTROL
4. LIQUID CRYSTAL DISPLAY 15. TALK OVER KEY
5. MICROPHONE 16. LEFT EAR SELECT KEY
6. NUMERIC KEYBOARD 17. RIGHT EAR SELECT KEY
7. TONE PRESENT INDICATOR 18. FREQUENCY SELECT KEY
8. PATIENT RESPONSE INDICATOR 19. FREQUENCY SELECT KEY
9. ESCAPE/MANUAL KEY 20. db(HL) LEVEL SELECT KEY
10. DATABASE/BEKESY KEY 21. db(HL) LEVEL SELECT KEY
11. PRINT/COMPUTER KEY 22. TONE PRESENT KEY

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4. THE KEYS

In order to use the audiometer effectively, the user first needs to be familiar
with function of the various keys. These are summarised below:

ESCAPE (Manual) This key allows the user to escape from any situation
without affecting any settings or date. The standby state
may always be reached by pressing ESCAPE one or
moretimes (depending on the current status).

DATABASE This key is mainly used to access the database functions of


(Bekesy) the CA850 Series 2. A menu provides the user with the
available options.

PRINT (Computer) This key allows the current audiogram to be printed.

Note: If "Select Test Mode" is illustrated on the LCD, then the above
three keys are used to specify which test mode is required.

YES This key is used to start a test, to action a menu option and
to answer questions displayed on the LCD.

NO This key is used to temporarily stop a test and to answer


questions displayed on the LCD.

TALKOVER This key may be pressed at any time during the test totalk
to the patient. The volume control to the left of this key
determines the audible level. The microphone is on the
top right of the front panel.

LEFT EAR These keys allow the user to specify which ear is to be
RIGHT EAR tested, or which resultant audiogram is to be viewed on
the LCD.

FREQ These keys are used to select a test frequency when a


manual test is being performed or to retest at a single
frequency after an unsatisfactory test has been performed
at a particular test frequency. A cursor on the LCD
illustrates the selected test frequency.

These keys are also used when moving between pages


within a patient record.

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LEVEL These keys are used to select a decibel level when a
manual test is being performed. A cursor on the LCD
illustrates the selected level which is also stated on the
bottom right hand corner of the LCD.

0 (Options) These keys may be used whenever numeric input is


1,2,3,4,5,6,7,8,9 required. (The keys duplicate those on the supplied
keyboard).

Note: When the audiometer is in its standby mode the OPTIONS key may
be pressed to gain access to the options menu. All options which the user
can change may be modified via this menu. (For further explanation
please see Options Section).

DEL When alphanumeric data is being entered this key allows


the last character to be deleted in a similar fashion to the
backspace key on a keyboard, enabling mistakes to be
corrected.

ENTER The enter key is used to action alphanumeric data which


has been entered.

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5. BACK PANEL LAYOUT

23. LEFT EAR OUTPUT JACK-SOCKET


24. RIGHT EAR OUTPUT JACK-SOCKET
25. RESPONSE SIGNAL JACK-SOCKET
26. EXTERNAL KEYBOARD SOCKET
27. RS232 CONNECTION
28. L.C.D. CONTRAST CONTROL
29. MAINS POWER INPUT SOCKET
30. POWER ON/OFF SWITCH

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6. AUDIOMETRY PREPARATION

Ambient Conditions

Audiometry should always be conducted in quiet conditions and the


audiometer so placed that the test subject cannot see the control panel or any
movement of the operator's hands. For further explanation on permissible
ambient noise levels, please refer to the audiometry standard ISO 6189-(1983).

Test Subject Preparation

Prior to testing, the following actions should be undertaken:-

(a) Spectacles, head ornaments (earrings etc) and hearing aids, when worn,
shall be removed.

(b) Hair shall be removed from between the earphone and the head.

(c) The earphones shall be fitted by a qualified person to ensure a proper


seal and comfortable fit, and test subjects shall be instructed not to touch
the earphones thereafter.

(d) Test subjects shall be instructed to avoid unnecessary movement, to


obviate extraneous noise.

Thereafter, and prior to the test tone presentation, the test subject shall undergo
a rest period of at least half a minute.

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7. AUDIOMETER CONNECTIONS

All sockets and jack plugs are colour coded to ensure correct identification and
connection of the audiometric equipment. In order to set up the CA850 in
preparation for conducting audiometric tests, the following connections need to
be made:-

(1) Connect the left and right headset, jack plugs and patient response jack
plug into the appropriate colour coded and labelled sockets on the back
panel.

Jack Plug Socket Colour


---------------------------------------------------------------------------------

Left headset Left ear (23) Blue


Right headset Right ear (24) Red
Patient response Patient response (25) Black

(2) Connect the keyboard into the corresponding labelled socket (26) on the
back panel (if keyboard is to be used).

(3) Connect RS232 plug into the corresponding labelled socket (27) on the
back panel (if audiogram results are to be transferred to an external
computer/computer program).

(4) Connect the power cable to the mains input socket (29) on the back
panel and to the mains supply.

Note: Unless otherwise specified, the CA850 is designed to operate from a


240v 50Hz mains power supply.

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8. OPERATING THE CA850 SERIES 2

8.1 Switching on the CA850

It is important to understand how the CA850 operates if one is to use the


audiometer to its maximum capabilities. Shown opposite is a schematic
drawing of the CA850 operating system. Each block of text corresponds
to a test information displayed on the Liquid Crystal Display (LCD).

Having completed the connections in accordance with the previous


section, turn the power ON/OFF switch (30) to the 'on' position. The
CA850 will now perform a number of internal validation tests to ensure
that the audiometer is functioning correctly. Power 'on' is indicated by
an illuminated green indicator on the front of the audiometer.

Upon passing the internal validation tests, the CA850 will display the
following message on the LCD:

This screen display corresponds to the test block opposite shown as:

Space is provided to the right of 'Examiner' to allow the person who is


to conduct the audiometric test to enter his or her name (via the
keyboard). (This information will appear on subsequent audiograms).
When completed press the YES key.

Note: All alphanumeric characters encapsulated within an


individual box on the schematic opposite refer to specific labelled
keys, i.e. YES refers to the key labelled 'YES'.

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8.2 Standby Mode

The standby mode is the mode that the CA850 will return to upon
completion of, or exiting from, a test or result process.

YES Proceed to the selection of test mode.

DATABASE The CA850 incorporates an internal database for storing


audiometric test results. Pressing the "database" key
allows various database actions to be viewed (for further
explanation please see database section).

OPTIONS The CA850 provides a significant number of options


which will allow the customisation of the audiometric test
to meet with your audiometric screening requirements.

8.3 Selection of Test Mode

The CA850 is capable of performing three different types of test, namely


Manual, Bekesy and Computerised.

-Select the test mode which is required

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9. MANUAL TEST MODE

9.1 Patient details

Upon selecting the manual test mode when "Select test mode" is displayed
on the LCD, the following display will appear:

YES Enter/Edit the current patient record as indicated on


subsequent displays. Each patient record covers three
pages (screens) of information on which personal details,
previous test results and current test results may be entered
and recorded. This is shown diagrammatically on the next
page.

NO Proceed with test. The consequences of this action would


be that either the current test details remain unchanged or
no personal details are entered.

DATABASE Allows the database to be accessed for a particular patient


record(s) held within the internal database.

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Page 1 (Personal Details)

Ident
Name
Fore
Test date
Address / Notes

Page 1

←→↑↓ Select No - Erase


Yes - Proceed Esc - Exit

Ident: Use the keyboard to enter test subject identification (clock or


employee number etc). The CA850 will accept a maximum of 12
alphanumeric characters. If a mistake is made on data entry use
the backspace key on the keyboard or the 'del' key on the numeric
entry keypad to correct the mistake. When the required data has
been entered press the enter key.

Name: Use the keyboard to enter the surname of the test subject. The
CA850 will accept a maximum of 14 alphanumeric characters.

Fore: Use the keyboard to enter the forename of the test subject. The
CA850 will accept a maximum of 14 alphanumeric characters.

Test Date: (Automatically entered by the CA850).

Address/ Only enter data if the test results are to be stored in the internal
Notes: memory or sent via the RS232 interface to an external computer
since an audiogram print out on the CA850 will not list address
information.

Press YES key to move on to Page 2.

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Page 2 Previous Test Information

In order for the HSE Categorisation procedure to be performed in full, the test
subject's date of birth and previous test results need to be entered. (For further
explanation please see Categorisation Section).

Birth date: Use the keyboard to enter the date of birth of the test
subject (day/month/year).

Previous test: If the test is for a baseline audiogram, then ignore this
input field and press the YES key to move onto the test.
However, if previous test results are known, use the
keyboard to enter the date of the previous audiogram
(day/month/year) and the individual threshold levels.
When complete press the YES key to move onto the test.

NB: Since there are no current test results at this stage, Page 3 of the
Patient Record cannot be viewed.

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9.2 Performing the test

The following procedure is only a suggested procedure for the completion of a


manual audiometry test and involves finding the lowest patient response level
and then confirming that response level through subsequent tone presents. The
threshold of hearing at any particular frequency is the lowest level at which the
test subject can identify the tone when it is re-introduced.

Consider the following example: If a test subject has, say, a hearing threshold
of 20dB at 1KHz this is determined by initially selecting a test frequency of
1KHz and a test tone of 30dB. If the test subject indicates that the tone has
been heard, the tone is decreased in 5dB steps until the test subject cannot hear
the tone (in this case the tones at 25dB and 20dB will be heard but not the tone
at 15dB). The operator shall then increase the test tone by 5dB and at 20dB the
test subject will indicate that the tone has been heard, i.e. the lowest level at
which the test subject can identify the tone when it is re-introduced.

Instructions to the test subject:

If the subject has not undergone an audiometry test before, the subject shall be
given instructions to press and release the response button upon hearing the
tone.

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In manual mode the following information will be illustrated on the LCD.

-Press Left or RIGHT to select the ear to be tested (left is the default choice).

-To select the required frequency level of the tone, use the Å or Æ keys (18)
and (19).

-To select the decibel level of the tone, use the Ç or È keys (20) and (21).

-To present a tone, press the touch sensitive key (22). The tone present
indicator (7) will illuminate if the subject indicates that the tone has been
heard.

-The message "Plot?" will appear on the top right of the screen. If the hearing
threshold is to be saved and plotted as the actual threshold at the particular
frequency press YES. Otherwise select another decibel level and present
another tone until the hearing threshold level at that particular frequency is
found.

-Move onto the next frequency required and repeat the above process.
Continue until both ears have been tested across the required frequency range.

-To view the comprehensive result, press LEFT or RIGHT and the information
will be displayed on the LCD.

The CA850 has the capabilities for the results to be:


-Printed as an archive quality audiogram
-Internally stored within the database
-Exported to an external computer/computer program

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9.3 To print results

-Press PRINT. The message "insert paper" appears on the top of the LCD.
-Ensure that the arrow printed on the paper and the arrow printed above the
paper slot (1) are facing each other.
-Feed paper into the entry slot until the paper is taken by the printer.

9.4 To store results within the internal database

-Press DATABASE
-Use Ç and È keys to select "store current data"
-Press YES

9.5 To transfer results to an external computer/computer program

-Press DATABASE
-Use Ç and È keys to select "Send to RS232"
-Press YES

9.6 New Patients

It is very important when conducting tests on a number of individuals, to


ensure that the current patient record held in memory is erased prior to
conducting a test on a new individual. Failure to perform this task could result
in inaccuracies arising between test results and patient details.

-Having completed the results process (print, stores, etc) press ESCAPE to
return to the standby mode
-Press YES to run a test
-Press MANUAL to select test mode
-Press YES to edit the current patient record
-Press NO to select the 'erase' option
-Press YES to erase the current patient record
-Enter new patient details as required and perform another manual test

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10. BEKESY TEST MODE

A method of automatic audiometry devised by Von Bekesy (1947) using pure


tone stimuli to track auditory thresholds.

In essence the principal behind the Bekesy test in that the patient adjusts the
presented decibel level according to his or her hearing threshold. The decibel
level decreases when the patient presses the signal response button upon
hearing the presented tone. Conversely when the patient can no longer hear the
presented tone, he or she will release the response button therefore allowing the
decibel level to increase until the presented tone is heard again. (This is best
explained with use of the following diagram which illustrates the principle of
the test).

1. The tone is presented at 40 dBHL, the test subject hears this tone and
presses the response button. The CA850 will now decrease the
presented tone in 2.5db steps until a point is reached whereby the test
subject can no longer hear a tone..

2. In this example, at 25db a tone can no longer be heard, therefore the test
subject releases the response button. The CA850 will now increase the
presented tone in 2.5db until a point is reached whereby the test subject
hears the tone again.

3. In this example, at 35db the tone is heard again, therefore the test
subject presses the response button. Again, the CA850 will now
decrease the presented tone in 2.5db steps until a point is reached
whereby the test subject can no longer hear a tone.

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4. In this example, at 25db a tone is no longer heard and the test subject
releases the response button. The CA850 will now increase the
presented tone in 2.5db steps until a point is again reached whereby the
test subject hears the tone and presses the response button.

When a number of these "peaks" and "valleys" have been consistently


performed, the CA850 will calculate an average. This average may then be
called the hearing threshold for that particular frequency. If a threshold has not
been obtained, a number of retries may be specified within the Options
Section. The CA850 will now present tones at the next specified test frequency
and perform a similar activity.

Instructions to the Patient

If the patient has not been subject to a Bekesy test before he or she should be
given instructions to press the patient response button when the tone is heard
and to release when the tone is no longer heard.

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To perform a Bekesy test:

10.1 Patient Details

Select the Bekesy test mode when "select test mode" is displayed on the
LCD. The following display will appear.

YES - Enter/Edit the current patient record as indicated on


subsequent displays. Each patient record covers three
pages (screens) of information on which personal details,
previous test results and current test results may be entered
and/or recorded. This is shown diagrammatically on the
next page.

NO - Proceed with test. The consequences of this action would


be that either the current record details remain unchanged
or no personal details are entered. It would be pertinent to
highlight the fact that any subsequent test results will be
attributed to the personal detail held within the
CURRENT record. Additionally, if no patient details are
entered then no patient details can be subsequently printed
or stored.

DATABASE - Allows the database to be accessed for particular patient


record or records held within the internal database.

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Page 1 (Personal Details)

Ident
Name
Fore
Test date
Address/Notes

Page 1
←→↑↓ Select No - Erase
Yes - Proceed Esc - Exit

Ident: Use the keyboard to enter test subject identification (clock


number etc). The CA850 will accept a maximum of 12
alphanumeric characters. If a mistake is made on data entry use
the backspace key on the keyboard or the 'del' key on the numeric
entry keypad to correct the mistake. When the required data has
been entered press the enter key.

Name: Use the keyboard to enter the surname of the test subject. The
CA850 will accept a maximum of 14 alphanumeric characters.

Fore: Use the keyboard to enter the forename of the test subject. The
CA850 will accept a maximum of 14 alphanumeric characters.

Test Date: (Automatically entered by the CA850).

Address/ Only enter data if the test results are to be stored in


Notes: the internal memory or sent via the RS232 interface to an
external computer since an audiogram print out on the CA850
will not list address information.

Press YES key to move on to Page 2.

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Page 2 - Previous Test Information

Birth date: / /
Prev test:
Previous
Left Right
500
1K
2K
3K
4K
6K
8K
Page 2

←→↑↓Select No - Erase
Yes - Proceed Esc - Exit

In order for the HSE Categorisation procedure to be performed in full, the test
subject's date of birth and previous test results need to be entered (for further
explanation, please see Categorisation Section).

Birth Date: Use the keyboard to enter the date of birth of the test
subject (day/month/year).

Previous Test: If the test is for a baseline audiogram, then ignore this
input field and press the Yes key to move onto the test.
However, if previous test results are known, use the
keyboard to enter the date of the previous audiogram
(day/month/year) and the individual threshold levels.
When complete press the Yes key to move onto the test.

N.B. Since there are no current test results at this stage, Page 3 of the Patient
Record cannot be viewed.

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10.2 Select Bekesy test criteria

Select as appropriate

10.3 Familiarisation and test

The message "familiar?" will appear on the top right of the LCD. The
CA850 gives the option of running a familiarisation routine prior to the
test proper. The advantages of this are that: (1) It ensures the patient
understands how to respond to the presented tones, and (2) It makes the
patient familiar to the test routine. The familiarisation routine can reduce
inconsistent patient responses, thus making the test more accurate and
time efficient.

- Press YES to run the familiarisation routine prior to the test.

- Press NO to run the test.

Note: After successful completion of the familiarisation routine the test


will start automatically.

The Bekesy test will now be performed according to the test criteria and
options selected. Upon completion of the test the CA850 allows the
results to be:

- Printed as an archive quality audiogram.


- Internally stored within the database.
- Exported to an external computer/computer program.

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10.4 To print results

- Press PRINT. The message "insert paper" appears on the top of the
LCD.
- Ensure that the arrow printed on the paper and the arrow printed above
the paper entry slot (1) are facing each other.
- Feed paper into the entry slot until the paper is taken by the printer.

10.5 To store results within the internal database

- Press DATABASE
- Use Ç and È keys to select "store current data"
- Press YES

10.6 To transfer results to an external computer/computer program

- Press DATABASE
- Use Ç and È keys to select "send to RS232"
- Press YES

10.7 New patients

It is very important when conducting tests on a number of individuals,


to ensure that the current patient record held in memory is erased prior
to conduction of a test on a new individual. Failure to perform this task
could result in inaccuracies arising between test results and patient
details.

- Having completed the results process (printed, store, etc.), press


ESCAPE to reset mode.
- Press YES to run a test.
- Press BEKESY to select test mode.
- Press YES to edit the current patient record.
- Press NO to select the 'erase' option.
- Press YES to erase the current patient record.
- Enter new patient details as required and perform another Bekesy test.

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11 COMPUTERISED TEST MODE

A method of automatic audiometry whereby 2 out of 3, or 3 out of 5 consistent


patient responses at one particular frequency constitute a pass at that particular
frequency. (See Option Section for selection of 2 out of 3, or 3 out of 5
responses).

Instruction to the patient

If the patient has not been subject to a computerised test before, the patient
should be given instruction to press and release the patient response button
once upon hearing a tone.

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To run computerised audiometric test

11.1 Patient Details

Select "Computer" test mode when the message "Select test mode" is
displayed on the LCD (by pressing COMPUTER key). The following
message will appear:

YES Enter/Edit the current patient record as indicated on subsequent


displays. Each patient record covers three pages (screens) of
information on which personal details, previous test results and
current test result may be entered and/or recorded. This is shown
diagrammatically on the next page.

NO Proceed with test. The consequences of this action would be that


either the current record details remain unchanged or no personal
details are entered. It would be pertinent to highlight the fact that
any subsequent test results will be attributed to the personal
details held within the CURRENT record. Additionally if no
patient details are entered the no patient details can be
subsequently printed or stored.

DATEBASE Allows the database to be accessed for particular patient record


or records held within the internal database.

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- 30 -
Page 1 (Personal Details)

Ident
Name
Fore
Test date
Address / Notes

Page 1

←→↑↓ Select No - Erase


Yes - Proceed Esc - Exit

Ident: Use the keyboard to enter test subject identification (clock


number etc). The CA850 will accept a maximum of 12
alphanumeric characters. If a mistake is made on data entry use
the backspace key on the keyboard or the 'del' key on the numeric
entry keypad to correct the mistake. When the required data has
been entered press the enter key.

Name: Use the keyboard to enter the surname of the test subject. The
CA850 will accept a maximum of 14 alphanumeric characters.

Fore: Use the keyboard to enter the forename of the test subject. The
CA850 will accept a maximum of 14 alphanumeric characters.

Test Date: (Automatically entered by the CA850).

Address/ Only enter information data if the test results are to be stored in
Notes: the internal memory or sent via the RS232 interface to an
external computer since an audiogram print out on the CA850
will not list address information.

Press YES key to move on to Page 2.

- 31 -
Page 2 - Previous Test Information

In order for the HSE Categorisation procedure to be performed in full, the test
subject's date of birth and previous test results need to be entered (for further
explanation, please see Categorisation Section).

Birth Date: Use the keyboard to enter the date of birth of the test
subject (day/month/year).

Previous Test: If the test is for a baseline audiogram, then ignore this
input field and press the Yes key to move onto the test.
However, if previous test results are known, use the
keyboard to enter the date of the previous audiogram
(day/month/year) and the individual threshold levels.
When complete press the Yes key to move onto the test.

N.B. Since there are no current test results at this stage, Page 3 of the Patient
Record cannot be viewed.

- 32 -
11.2 Select computerised test criteria

11.3 Familiarisation and test

The message "Familiarise?" will appear in the top right of the LCD. The
CA850 gives the option of running a familiarisation routine prior to the
test proper. The advantages of this are that, (1) It ensures the patient
understands how to respond to the presented tones, and (2) It makes the
patient familiar to the test routine. The familiarisation routine can reduce
inconsistent patient responses, thus making the test more accurate and
time efficient.

-Press YES to run the familiarisation routine prior to the test.


-Press NO to run the test.

Note: After completion of the familiarisation routine the test will


start automatically.

The computerised test will now be performed according to the test


criteria and options selected. Upon completion of the test the CA850
allows the results to be:

-Printed as an archive quality audiogram.


-Internally stored within the database.
-Exported to an external computer/computer program.

- 33 -
11.4 To Print Results

-Press PRINT. The message "insert paper" appears on the top of the
LCD.
-Ensure that the arrow printed on the paper and the arrow printed above
the paper entry slot (1) are facing each other.
-Feed paper into the entry slot until the paper is taken by the printer.

An archive quality audiogram will now be printed automatically listing


threshold levels, test information and categorisation (if applicable).

11.5 To Store Results Within the Internal Database

-Press DATABASE.
-Use UP and DOWN keys to select "store current data".
-Press YES.

11.6 To transfer results to an external computer/computer program

-Press DATABASE.
-Use UP and DOWN keys to select "send to RS232".
Press YES.

11.7 New Patients

It is very important when conducting tests on a number of individuals,


to ensure that the current patient record is erased prior to conducting a
test on a new individual. Failure to perform this task could result in
inaccuracies arising between test results and patient details.

-Having completed the results process (print, store etc), press ESCAPE
to return to the reset mode.
-Press YES to run a test.
-Press COMPUTER select test mode.
-Press YES to edit the current patient record.
-Press NO to select the 'erase' option.
-Press YES to erase the current patient record.
-Enter new patient details as required and perform another computerised
test.

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12 DATABASE FUNCTIONS

The database facility may be accessed from the standby mode, at the patient
details entry stage or upon completion of a test.

The main database menu is as follows:

12.1 View/Edit current record.


12.2 Store current record.
12.3 Send to RS232.
12.4 Get/Delete a record.
12.5 Convert to previous.
12.6 Send batch to RS232.
12.7 Import from RS232
12.8 Database status

Note: The database will store up to 415 complete audiograms whilst the
audiometer is switched off. However, the storage of test results over
time is dependent upon the audiometer being switched on at least once a
month (this enables the memory system to be refreshed).

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- 36 -
12.2 Store current data

To store the current record within the internal database

- Use UP and DOWN keys to select function


- YES to store the current record
- ESCAPE to exit from the database into standby mode

12.3 Send to RS232

If the results are to be stored/viewed within an external


computer/computer program, the CA850 must be connected to the
external computer via the RS232 link. (See appendix for specifications
regarding the RS232 link).

-Use UP and DOWN keys to select function


-YES to send test results
-ESCAPE to exit from database into standby mode

12.4 Get/Delete a record

This option will facilitate the retrieval and,/or deletion of a record(s)


stored within the internal database. If more than one record exists that
matches the search parameters, then these subsequent records can be
readily viewed without having to continuously retrieve records.

-Use UP and DOWN keys to select function


-YES to get/delete a record

The following display will appear:

Search details
Enter patient surname or ident:
xxxxxxxxxxxxxxx
Find exact match?

YES - Name/ident is fully specified


NO- Name/ident is blank or part
specified

Enter the search criteria and press either the YES or NO key as appropriate.

- 37 -
If a record or records exist(s) within memory that matches the search criteria
then that record will be displayed. The page layout is very similar to that of the
current record display. However, the control functions listed at the bottom of
the display are different.

(Ç & È KEYS) Will facilitate the viewing of other records that match the
search criteria. The match (record) number is indicated in
the top right of the display to avoid errors being made.

(Å & Æ KEYS) Will facilitate the viewing of pages 1, 2 and 3 of the


selected record.

YES Will retrieve a record held in memory and place it within


current memory where it may be viewed, printed, sent via
RS232 to a computer or updated in preparation for another
test to be performed (converting the current audiogram to
previous test results).

DELETE Will delete the displayed record from the internal


database. After pressing DELETE, press either YES to
erase or NO to escape.

12.5 Convert to previous

If previous test results exist for the test subject and these records reside
within the internal database, it may be more time efficient to use this
function to complete pages 1 and 2 of the record (personnel details and
previous results). Therefore the need to re enter existing information is
removed.

This function will convert audiogram results stored as the current results
(page 3) of a record into the previous results (page 2) of a record.

It does not effect the stored record in any manner.

Use Ç and È keys to select function


YES to perform task
ESCAPE to exit from database into standby mode. At which point a
normal test routine may be performed.

- 38 -
12.6 Send batch to RS232
This function will export all records stored within the database to an
external computer which has configured to accept the test information
Alternatively only audiograms performed after a certain date can be
transferred by using the backspace key to delete the displayed date and
entry of the required test date as appropriate.

-Use Ç and È keys to select function


-Perform the appropriate action ensuring that the receiving
computer/computer program has been set up to receive the data. Press
escape to return to the database menu.

12.7 Import from RS232


This function will import test results from a computer/computer
program which has been configured to transfer the data in the required
format. If selected this function has a number of options:

(1) DEL - Erase whole database; prior to data transfer the operator
may require the erasure of all existing records in the internal
database. Thus the only records within the database will be the
transferred records.

(2) YES - Store all records; the operator has the option of
automatically storing all records selected for transfer from the
computer/computer program.

(3) NO - Confirm each record as it is received; the operator has the


option of reviewing each record as it is transferred.

-Use Ç and È keys to select a function.


-Perform the appropriate action ensuring that the transmitting
computer/computer program has been set up to transmit the data and
that the audiometer has enough memory to accept all the information.
- Press Escape to return to the database menu.

12.8 Database Status


This facility gives an indication of the total number of audiogram
records stored within the internal database.

-Use Ç and È keys to select function.


-YES to perform task.
-ESCAPE to return to the database menu.

NB To erase the entire internal database, refer to the "Options" Section.

- 39 -
13 AUDIOMETRIC TEST OPTIONS

The options menu will allow various functions to be incorporated into the
audiometric test to suit your particular audiometric requirements.

The options menu may be accessed from the reset mode by pressing the
OPTIONS key. Once selected the option will be retained indefinitely until
changed (regardless of whether the audiometer has power supplied to it).

The CA850 provides the following options:

13.1 Set time.


13.2 Set date.
13.3 Change pens.
13.4 8KHz frequency.
13.5 Retries.
13.6 Run through.
13.7 Beeps after test.
13.8 Threshold tries.
13.9 Pulse in manual.
13.10 Expanded graph.
13.11 Print thresholds.
13.12 Print previous.
13.13 RS232 Mode - Series 1 or 2.
13.14 Paper alignment.
13.15 Erase all database.

13.1 Set time


The time when the test is conducted is printed/stored automatically.

-Press Ç and È keys to select function.


-Press YES to alter.
-Enter new time by using backspace to delete old time. Use number
keys to enter new time.
-Press YES to perform task.

13.2 Set date


The date when the test is conducted is printed/stored automatically.

-Press Ç and È keys to select function.


-Press YES to alter.
-Enter new date.
-Press YES to perform task.

- 40 -
13.3 Change pens

This option facilitates the changing of the printer pens.

-Use Ç and È keys to select function


-Press YES to perform. Immediately, the pen carriage will move to the
right hand side of the printer and the following message will be
displayed:
Options

Change BLACK pen


carefully
Press YES when ready

-Remove the perspex printer cover


-Directly below the pen carriage is a small white lever. Press this lever
towards you carefully, ensuring the extracted pen does not fall into the
printer.
-Replace the extracted pen with a new pen of the same colour, ensuring
that the nib of the pen is located through the metal front plate of the pen
carriage
-Press YES when the new pen has been located correctly.
-Using the same procedure replace all four pens

13.4 8KHz Required

The CA850 is built to ISO 6189. This standard specifies that


audiometric testing at 8KHz is optional.
-Use Ç and È to select function
-Press YES or NO to suit your screening requirements

13.5 Retries

A hearing threshold level cannot be established in Bekesy or


Computerised mode if inconsistent patient responses are continually
recorded. This option will facilitate an automatic retest at a failed
frequency prior to the continuation for the audiometric test.

-Use Ç and È to select function


-Press YES or NO to increase or decrease the number of retries. The test
range is 0 to 4 retries at one particular frequency.

- 41 -
13.6 Run through

If the "run through" option is selected, the computerised test will always
proceed from start to finish regardless of whether threshold levels have
been established for particular frequencies. Consequently, if the patient
does not respond appropriately during the test the results may end up
incomplete. If "run through" is NOT selected and the patient does not
respond appropriately (i.e. inconsistent responses), the CA850 will alert
the operator that there is a problem. At this stage the operator may wish
to further instruct the patient using the 'talkover' facility before retesting
of that particular frequency.

-Use Ç and È to select function.


-Press YES to select "run through" or press NO to highlight
inconsistent responses.

13.7 Beeps after test

When an automatic test has been completed this function, if enabled,


will ensure that an audible tone is continually generated to alert the
operator or examiner that the test has finished.

-Use Ç and È to select function.


-Press YES or NO to enable or disable the function.

13.8 Threshold tries

When the CA850 is in "computerised" test mode, this option allows the
pass criteria at one particular frequency to be set at either 2 out of 3 or 3
out of 5 consistent responses.

-Use UP and DOWN to select function


-Press YES to select 2 out of 3 consistent responses - press NO to select
3 out of 5 consistent responses.

13.9 Pulse in manual

In manual operation, when the touch sensitive tone present key is


pressed, a tone is presented once. This option will enable the tone to be
presented repeatedly so long as the tone present key is pressed.

-Use UP and DOWN to select function


-Press YES to select repeated tone present
-Press NO to select present once

- 42 -
13.10 Expanded graph

This option will allow viewing in graphics, of all tone present and
patient responses at each particular test frequency when the audiometer
is in Bekesy or Computer test mode. On completion of the test the LCD
will display the composite results.

-Use Ç and È keys to select function


-Press YES to enable the expanded graph format
-Press NO for normal graph format

13.11 Print thresholds

This function will allow the operator to choose the style in which the
current thresholds are recorded on the print-out. The choices are (1) a
full tracing which lists all tone presents, subsequent patient responses
and thresholds or (2) a print-out which displays thresholds only, i.e. x
for a left ear threshold and 'o' for a right ear threshold.

-Use Ç and È keys to select function.


-Press YES key to print thresholds only.
-Press NO key to print a full tracing.

13.12 Print Previous

When discussing test results with test subjects, if the results are shown
in a graphical format in addition to a text format, comprehension and
hence understanding for hearing conservation programmes should be
improved.

-Use Ç and È keys to select function.


-Press YES key to print current and previous results as a graphics print-
out.
-Press NO key to print only current thresholds.

- 43 -
13.13 RS232 Mode - Series 1 or 2

The RS232 facility will allow test results to be exported and imported to
and from an external computer/computer program (for further
explanation please refer to RS232 Section).

-Use Ç and È keys to select function


-Press YES to include facility
-Press NO to exclude facility

13.14 Paper alignment

This allows the actual print-out on the paper to be moved left, right, up
or down as required. (The alignment is set during manufacture and
should not need adjustment).
-Use Ç and È keys to select function
-Enter offset, + or - 10 for left/right alignment
-Press YES to perform
-Enter offset, + or - 10 for up/down alignment
-Press YES to perform

13.15 Erase all database

This option will erase all test results that are currently held within the
internal database.

-Use Ç and È keys to select function


-Press YES to select erase facility. The following display will appear:

Press DEL to erase the


whole database

-Press DEL or ESCAPE as appropriate.

- 44 -
Exiting options menu

- Press ESCAPE, the following message will be displayed:

Save changes?

- Press YES to save the changes


- Press NO to return to the option selection prior to entry into the options
menu.

- 45 -
14. TECHNICAL SPECIFICATION

Frequencies: 500, 1K, 2K, 3K, 4K, 6K, 8K

Frequency Accuracy: + or - 1.0%

Purity: Better than 3%

Output Level Range: -10dB to 90dB HL

Output Level Steps: 2.5dB (Bekesy)


5dB (Computer and Manual)

Output Level Accuracy + or - 1/2dB

Calibration Adjustment: + or - 10dB

Built-in Graphics LCD Display 82mm x 102mm Display Area

Printer 4 colour, permanent ink

Serial Interface: RS232, 9600baud for audiogram export

Keyboard Interface For external IBM compatible keyboard

Real Time Clock: Battery backed, keeps track of time and


date

Internal Database: 415 Records including name and address.

- 46 -
15. CONNECTORS

Mains Input: IEC Inlet, fused/filtered


Left and Right Outputs: 1/4" Jack Socket

Patient Response Switch: 1/4" Jack Socket

RS232 Interface: 9-way D-type socket

Keyboard: 5-way DIN socket (180deg)

16. PHYSICAL PARAMETERS

Dimensions (Main Unit): 420mm wide, 250mm deep


120mm high (rear), 50mm high
(front)

Operating Temperature: 0 to 40deg C

Storage Temperature -20 to 70deg C

Humidity: 5 to 95% non-condensing

Power Requirement: 240 volts, 50Hz, 50watts max

Paper Requirement: Pre-printed single sheets


115mm wide x 310mm long

- 47 -
APPENDIX A - AUTOMATIC CATEGORISATION

Assessment of audiogram should be undertaken by a qualified person. The


CA850 Audiometer does, however, automatically categorise audiograms. This
categorisation occurs whenever an audiogram (manual, computerised or self-
recording) is printed out or stored electronically. There are five categories
(1,2,3,4 and 5) and each of these correspond to a test criteria which is applied
to various parts of the audiometric test data (left/right ear, high/low frequency).
The resultant categorisation comprises a list of category numbers each with an
associated coding which shows what part of the audiogram data caused that
number to be assigned. This list of numbers may include 5 only (normal
hearing), or any combination of the other numbers.

The categorisation follows this scheme:

(a) The hearing levels of each ear are summed over the low frequencies:

500Hz 1kHz 2kHz

and high frequencies: 3kHz 4kHz 6kHz

(b) The audiogram is then categorised as follows:

Category 1

The subject is assigned this category if the sum of the hearing levels for the left
or right ear, high or low frequencies has:

(1) Increased by 30dB or more compared with the last audiometric test if
the period since the last test is less than or equal to 3 years.

(2) Increased by 45dB or more if the period since the last test is greater than
3 years.

Category 2

The subject is assigned this category if the difference in the sum of hearing
levels between the ears exceeds either:

(1) 45 dB for low frequencies

(2) 60 dB for high frequencies

- 48 -
Categories 3 and 4

The sums of the hearing levels for each ear should be compared with the values
in the table below.

If the sum of either ear exceeds the REFERRAL LEVEL for either low or high
frequencies or both, the case is assigned category 3.

If the sum of either ear exceeds the WARNING LEVEL, either for low or high
frequencies or both, but does not exceed the corresponding referral level the
case is assigned category 4.

WARNING LEVEL (4) REFERRAL LEVEL (3)

AGE LOW HIGH LOW HIGH


FREQUENCIES FREQUENCIES FREQUENCIES FREQ.

20-24 45 45 60 75
25-29 45 45 66 87
30-34 45 45 72 99
35-39 48 54 78 111
40-44 51 60 84 123
45-49 54 66 90 135
50-54 57 75 90 144
55-59 60 87 90 144
60-65 65 100 90 144
65+ 70 115 90 144

Cases which have not been assigned categories 1,2,3 or 4 are categorised 5.

The coding following category number is as follows:

Category 1 and 3 and 4:

LB - Left Both (high and low frequency)


LL - Left Low Frequency
LH - Left High Frequency
RB - Right Both (high and low frequency)
RL - Right Low Frequency
RH - Right High Frequency

- 49 -
Category 2:

B - Both high and low frequencies


L - Low frequencies only
H - High frequencies only

Note that the letter "L" is used to indicate both left and low in the above
codings. There is no possibility of ambiguity, however, as in the case of
categories 1, 3 and 4 the first letter is always for the ear (left or right) and the
second for the frequency band (high, low or both); in the case of category 2,
the single letter always indicates the band (high, low or both).

----------------------------------------------------

If previous test data for the patient has not been entered, the categorisation is
still carried out. Category 1 cannot, however, be determined and this is
indicated by the coding: N/A.

A typical categorisation might be:

1-N/A 2-L 3-LB 4-RH

This indicates the following:

(a) Category 1 is not applicable because previous data was not entered (or
was incomplete).

(b) Category 2 was assigned for the LOW frequency band only.

(c) Category 3 was assigned for the LEFT ear on BOTH high and low
frequencies.

(d) Category 4 was assigned for the RIGHT ear on the HIGH frequency
band.

Notes:

(a) If the patient's age is less than 20, categorisation will not be performed
and the message "AGE UNDER 20" will be printed.

(b) If patient details are not entered or are incomplete, the message: "DATA
INCOMPLETE" will be printed.

- 50 -
(c) Categories 2, 3 and 4 are performed on the current audiogram. However,
if there is no baseline/previous audiogram and categories 2, 3 and 4 are
not assigned, the message "1, 5 - N/A" will be printed, i.e. category 5
cannot be assigned because the category 1 evaluation has not been
performed.

APPENDIX B - RS232 Data Formats

Standard (Enhanced RS232 within the options page set to NO)

The RS232 data is transmitted as ASCII characters. The standard RS232 data
format consists of a number of lines, all separated by CR and LF characters.
The first line comprises a start of block character (<) and the last line an end of
block character (>). Audiometric values are separated by commas. The format
is as follows:

<
Test Mode (MANUAL, COMPUTER, AUTOMATIC)
Time of Test (HH:MM)
Date of Test (DD/MM/YY)
Patient Number (up to 8 digits)
Patient Age (DD/MM/YY)
Date of Last Test (DD/MM/YY)
Date Calibrated (DD/MM/YY)
500,1k,2k,3k,4k,6k,8k (Previous Left values)
500,1k,2k,3k,4k,6k,8k (Current Left values)
500,1k,2k,3k,4k,6k,8k (Previous Right values)
500,1k,2k,3k,4k,6k,8k (Current Right values)
Categorisation
>

- 51 -
Enhanced (Enhanced RS232 within the options page set to YES)

The RS232 data is transmitted as ASCII characters. The enhanced data format
outputs a complete audiometric record on a line with comma separation
between items. A CR and LF character terminates each line. Test information
and time are in inverted commas ("), dates are in the form DD/MM/YY and
numbers are all integers with no extra delimiting characters. The data format is
compatible with many standard databases (e.g. Borland Paradox) and
spreadsheets (e.g. Lotus 123) and may be imported directly once downloaded
from the audiometer onto a disc file. The date items are output in the following
sequence:

Test Mode (MANUAL, COMPUTER, AUTOMATIC)


Time of Test (HH:MM)
Date of Test (DD/MM/YY)
Ident (Up to 12 digits)
Patient Surname (Up to 14 digits)
Patient Forename (Up to 14 digits)
Address Line 1 (Up to 19 digits)
Address Line 2 (Up to 19 digits)
Address Line 3 (Up to 19 digits)
Address Line 4 (Up to 19 digits)
Address Line 5 (Up to 19 digits)
Address Line 6 (Up to 19 digits)
Patient Date of Birth (DD/MM/YY)
Date of Previous Test (DD/MM/YY)
Date of Last Calibration (DD/MM/YY)
500,1k,2k,3k,4k,6k,8k (Previous Left values)
500,1k,2k,3k,4k,6k,8k (Current Left values)
500,1k,2k,3k,4k,6k,8k (Previous Right values)
500,1k,2k,3k,4k,6k,8k (Current Right values)
Categorisation
Examiner

- 52 -
RS232 Connection Details

The RS232 output is via a 9-way D-type male connector. A cable with a 9-
way female D-type is required to make connection. The audiometer is
configured as data terminal equipment (DTE) with the same pin-outs as an
IBM AT computer with a 9-way serial port. The pin connections are as
follows:

9 - way Name Input/Output Equivalent pin number


male on a 25-way connector
1 DCD Not used 8
2 RXD Data Input 3
3 TXD Date Output 2
4 DTR Output(+12v) 20
5 GND Ground 7
6 DSR Not used 6
7 RTS Output(+12v) 4
8 CTS Handshake Input 5
9 Not used Not used 22

Connection to a Computer with a 25-way Connector

If the CA 850 Series audiometer is to be connected to a computer (or other


DTE device) with a 25-way connector, a cable with the following connections
is recommended:

- 53 -
Connection to a Computer with a 9-way Connector

If the CA850 Series audiometer is to be connected to a computer (or other DTE


device) with a 9-way connector, a cable with the following connections is
recommended:

RS232 Data Rate, Bits & Parity

Data is transmitted at 9600 baud with 8 data bits, 2 stop bits and no parity.

RS232 Flow Control

Flow control is implemented (Software Revision R2.5 onwards) to regulate the


flow of data from the CA850 Series 2 to the computer. Data transmission from
the audiometer is halted if the CTS line into it is inactive (-12Volts). When it
is active (+12Volts), data transmission can resume. If no handshake is
required, the CTS input (pin 8) may be linked to the RTS output (pin 7) to hold
it in its active state.

Handshake is implemented (Software Revision R2.9 onwards) to regulate the


flow of data to the CA850 Series 2 from a computer. Data transmission from
the computer is halted if the DTR line from the CA850 is inactive (-12Volts).
When the CA850 is able to receive data, the DTR line goes active (+12V).

- 54 -
- 55 -

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