18VAC30-21-145. Limited cerumen management.
A. In order for an audiologist to perform limited cerumen management, he shall:
1. Be a graduate of a doctoral program in audiology that is accredited by the Council on Academic Accreditation of the American Speech-Language-Hearing Association or other accrediting body recognized by the board and that included didactic education and supervised clinical experience in cerumen management as specified in subsection B of this section; or
2. Complete a course or workshop in cerumen management that provides training as specified in subsection B of this section and that is approved by the American Speech-Language Hearing Association or the American Academy of Audiology.
B. An audiologist shall maintain documentation evidencing satisfactory completion of training in cerumen management to include the following:
1. Recognizing the presence of preexisting contraindications that necessitate referral to a physician;
2. Recognizing patient distress and appropriate action to take if complications are encountered;
3. Use of infection control precautions;
4. Procedures for removal of cerumen, including cerumen loop, gentle water irrigation, suction, and the use of material for softening;
5. Observation of each type of cerumen management procedure performed by a qualified audiologist or physician; and
6. Successful performance, under direct supervision by an audiologist qualified to perform cerumen management or a physician, of each type of cerumen management procedure.
C. An audiologist shall not perform cerumen management on a patient who has any of the following preexisting contraindications:
1. A perforated tympanic membrane;
2. Inflammation, tenderness, drainage, or open wounds or traces of blood in the external ear canal;
3. History of ear surgery that results in distortion of the external ear canal;
4. HIV infection or bleeding disorders;
5. Actual or suspected foreign body in the ear, excluding hearing aid components that are located in the lateral one-third portion of the ear canal;
6. Stenosis or bony exostosis of the ear canal; or
7. Cerumen impaction that totally occludes the visualization of the tympanic membrane.
D. An audiologist performing cerumen management shall:
1. Obtain informed consent of the patient or legally responsible adult and document such consent and the procedure performed in the patient record.
2. Refer patients to a physician if they exhibit contraindications or experience any complication, such as dizziness, during the procedure.
Statutory Authority
§ 54.1-2400 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 32, Issue 26, eff. September 21, 2016.