Talk:Auditory brainstem response

Untitled

The following sentences appear to have been taken verbatim from the referenced eMedicine website: "The procedure was first described by Jewett and Williston in 1971. ABR audiometry is the most common application of auditory evoked responses. Test administration and interpretation are typically performed by an audiologist." I did not check if other text from this document was also copied, but unless permission was obtained this violates WebMD's copyright.

ABR/BAER

Why is the hospital performing this test on me. I am 65 years old and in good health, and I have pretty good hearing? —Preceding unsigned comment added by 75.212.139.220 (talk) 19:29, 28 February 2010 (UTC)

I really can't say with any authority why they are doing this on you particularly; but generally it is done on adults where there is doubt about the veracity of the subjective (pure tone audiometry) results —Preceding unsigned comment added by Si1965 (talk • contribs) 22:28, 22 November 2010 (UTC)

Question moved from article.

A new user, Cwchet, posted a question in the article. I have removed it, and paste it here for consideration by an editor competent to answer this: "q: At Sample rate = 512, this provides only ~5 data samples during a time window of 10ms, which is far less than the 1000 minimum written below and too few to create a meaningfull waveform. Should this be 512k?" RolandR (talk) 00:03, 3 July 2013 (UTC)

No, it's definitely not 512k. The expression 'sample rate' is a bit misleading, to be honest. It actually refers to the number of data points plotted within the time window to create the waveform (on my machine it is labelled "#points"). The '1000 minimum' referred to in the question is a slightly different thing; this refers to the number of responses used to create the averaged waveform. BbBrock (talk) 11:55, 20 September 2013 (UTC)

Generating sites

There's been some recent activity changing the generating sites of the waves of the ABR, and even how many waves there are, with no discussion. I think before any other changes are made on this topic, there should be discussion here of exactly what sources are being used for the information people want to add or subtract. If they are books or other sources most people do not have direct access to, I think quotations should be provided as well. Also, please do not use double-bracket links for Wiki articles that do not exist. Eflatmajor7th (talk) 04:01, 12 November 2013 (UTC)

External links modified

Hello fellow Wikipedians,

I have just modified 2 external links on Auditory brainstem response. Please take a moment to review my edit. If you have any questions, or need the bot to ignore the links, or the page altogether, please visit this simple FaQ for additional information. I made the following changes:

• Added archive https://web.archive.org/web/20060902205053/http://www.communication.northwestern.edu/publication/11873412261c717de6.pdf to http://www.communication.northwestern.edu/publication/11873412261c717de6.pdf
• Added archive https://web.archive.org/web/20060901100702/https://www.communication.northwestern.edu/brainvolts/ to http://www.communication.northwestern.edu/brainvolts/

When you have finished reviewing my changes, please set the checked parameter below to true or failed to let others know (documentation at {{Sourcecheck}}).

This message was posted before February 2018. After February 2018, "External links modified" talk page sections are no longer generated or monitored by InternetArchiveBot. No special action is required regarding these talk page notices, other than regular verification using the archive tool instructions below. Editors have permission to delete these "External links modified" talk page sections if they want to de-clutter talk pages, but see the RfC before doing mass systematic removals. This message is updated dynamically through the template {{source check}} (last update: 5 June 2024).

• If you have discovered URLs which were erroneously considered dead by the bot, you can report them with this tool.
• If you found an error with any archives or the URLs themselves, you can fix them with this tool.

Cheers.—InternetArchiveBot (Report bug) 08:32, 21 October 2016 (UTC)

"BAER" listed at Redirects for discussion

An editor has asked for a discussion to address the redirect BAER. Please participate in the redirect discussion if you wish to do so. Beeblebrox (talk) 02:20, 1 October 2019 (UTC)

Merger discussion

I want to merge this page Brainstem auditory evoked potential to this page Mr Nerd 96 (talk) 04:45, 16 February 2024 (UTC)

Removed lengthy story about sedation

All of this is OR and I could just delete it. But I'm preserving it here.

Sedation protocols

Common sedative used

To achieve the highest-quality recordings for any recording potential, good patient relaxation is generally necessary. However, many recordings can be filled and contaminated with myogenic and movement artifacts. Patient restlessness and movement will contribute to threshold overestimation and inaccurate test results. In most cases, an adult is usually more than capable to provide a good extratympanic recording. In transtympanic recordings, a sedative can be used when time-consuming events need to take place. Most patients (especially infants) are given light anesthesia when test transtympanically.

Chloral hydrate is a commonly prescribed sedative, and most common for inducing sleep in young children and infants for AEP recordings. It uses alcohol to depress the central nervous system, specifically the cerebral cortex. Side effects of chloral hydrate include vomiting, nausea, gastric irritation, delirium, disorientation, allergic reactions and occasionally excitement – a high level of activity rather than becoming tired and falling asleep. Chloral hydrate is readily available in three forms – syrup, capsule and suppository. Syrup is most successful for those 4 months and older, proper dosage is poured in an oral syringe or cup. The syringe is used to squirt in the back of the mouth and then the child is encouraged to swallow. To induce sleep, dosages range anywhere from 500 mg to 2g, the recommended pediatric dose is equal to 50 mg per kg of body weight. A second dose no greater than the first dose, and an overall dose not exceeding 100 mg/kg of body weight can be used if the child does not fall asleep after the first dose. Sedation personnel should include a physician and a registered or practical nurse. Documentation and monitoring of physiologic parameters is required throughout the entire process. Sedatives should only be administered in the presence of those who are knowledgeable and skilled in airway management and cardiopulmonary resuscitation (CPR).

Increasingly, Propofol is used intravenously via infusion pump for sedation.

Procedures

A consent form must be signed and received from the patient or guardian indicating the conscious sedation and the procedure being performed. Documented medical evaluation for pre-sedation purposes including a focused airway examination either on the same day as the sedation process or within recent days that will include but not limited to:

• Age and weight
• A complete and thorough medical history including all current medications, drug allergies, relevant disease, adverse drug reactions (especially relevant if any previous reaction to sedatives) and all relevant family history
• Verify any airway or respiratory problems
• All medications taken (including dosage and history of specific drug use) on the day of the procedure
• Food and fluid intake within the 8 hours prior to sedation – light breakfast or lunch 1–2 hours prior to testing reduces likelihood of gastric irritation (common with chloral hydrate).
• All vital signs

All orders for conscious sedation for patients must be written. Prescriptions or orders received from areas outside of the conscious sedation area are not acceptable. There has to be a single individual assigned to monitor the sedated patient's cardiorespiratory status before, during and after sedation.

If patient is deeply sedated, the individual's only job should be to verify and record vital signs no less than every five minutes. All age and size appropriate equipment and medications used to sustain life should be verified before sedation and should be readily available at any time during and after sedation.

The medication should be administered by a physician or nurse and documented (dosage, name, time, etc.). Children should not receive the sedative without supervision of a skilled and knowledgeable medical personnel (at home, technician). Emergency equipment including crash cart must be readily available and respiration monitoring should be done visually or with stethoscope. Family member needs to remain in room with patient, especially if tester steps out. In this scenario, respiration can be monitored acoustically with a talk-back system microphone placed near patient's head. Medical personnel should be notified of slow respiration state.

After procedure is over, patient must be continuously observed in the facility that is appropriately equipped and staffed because patient's typically "floppy" and have poor motor control. Patients shouldn't stand on their own for the first few hours. No other medications with alcohol should be administered until patient is back to normal state. Drinking fluids is encouraged to reduce stomach irritation. Each facility should create and use their own discharge criteria. Verbal and written instructions should be provided on the topics of limitations of activity and anticipated changes in behavior. All discharge criteria must be met and documented before the patient leaves the facility.

Some criteria prior to discharge should include:

• Stable vital signs similar to those taken pre-procedure
• Patient is at the level of consciousness pre-procedure
• Patient has received post-procedure care instructions.

77.188.115.73 (talk) 00:51, 5 October 2024 (UTC)