POPULATION  OF  INTEREST

All patients exposed to a blast, and patients who develop symptoms consistent with noise trauma.

INTENT  (EXPECTED  OUTCOMES)

1. All patients exposed to blast, with symptoms of acoustic trauma (e.g., tinnitus, vertigo, muffled hearing, drainage from ear, fullness in the ear, blast injury or documented noise trauma) have documented tympanic membrane examination and objective hearing evaluation if available.
2. All patients exposed to blast, with subjective hearing loss or tinnitus persisting greater than 72 hours have a documented hearing test or audiogram.
3. All patients in the population of interest with absolute indications for ENT referral (per CPG) have a documented ENT evaluation.

PERFORMANCE/ADHERENCE  METRICS

1. Patients of interest have a documented tympanic membrane exam.
2. Patients with subjective hearing loss or tinnitus persisting >72h have a hearing test or audiogram.
3. Patients with absolute indications for ENT referral have a documented ENT examination.

DATA  SOURCE

• Patient Record
• Department of Defense Trauma Registry (DoDTR)
• Joint Hearing Loss and Auditory System Injury Registry (JHASIR)

SYSTEM  REPORTING  &  FREQUENCY

The above constitutes the minimum criteria for PI monitoring of this CPG. System reporting will be performed annually; additional PI monitoring and system reporting may be performed as needed.

The system review and data analysis will be performed by the JTS Chief and the JTS PI Branch.

RESPONSIBILITIES

It is the trauma team leader’s responsibility to ensure familiarity, appropriate compliance, and PI monitoring at the local level with this CPG.