Questionnaire-EarHealthAndHearing

Sourcecsiro.fhir.au.smartforms#current:Smart Forms (v4.0.1)
resourceTypeQuestionnaire
idEarHealthAndHearing
canonicalhttp://www.health.gov.au/assessments/mbs/715/EarHealthAndHearing
version0.1.0
statusdraft
publisherAEHRC CSIRO
nameEarHealthAndHearing
titleAboriginal and Torres Strait Islander Health Check - Ear Health And Hearing
date2022-05-24
experimentalfalse
descriptionEar Health And Hearing sub-questionnaire for Aboriginal and Torres Strait Islander Health Check.
copyrightCSIRO © 2022+; Licensed under Apache License, Version 2.0
jurisdictionsau
Usages(none)

Ear health and hearing

  • linkId: de71bbd0-178c-4974-9c75-55d5a48c66f7

In progress

  • linkId: CD-in-progress-6
  • Enable When: todo

Complete

  • linkId: CD-complete-6
  • Enable When: todo

Child listening concerns

  • linkId: f3473e82-4336-4858-96de-3a61eff5abfb

Is there anything that you are worried about with your child's listening?

  • linkId: f982c374-f023-4e68-8968-1f1f5d3969ae
  • Answers: #YesNo

Details

  • linkId: 297114f4-8c3f-4916-b840-c38ea14d37b1
  • Enable When: todo

Child language concerns

  • linkId: d2a3a346-7b20-4634-beb4-f2bdc7252fe5

Is there anything you are worried about with your child's language/talking?

  • linkId: 06c150f8-4d54-4d10-aeff-2ef7567b6812
  • Answers: #YesNo

Details

  • linkId: 30dc1581-f6b7-49f0-be09-3902178a495f
  • Enable When: todo

Child snoring

  • linkId: 6662bc91-fd05-4ea0-a96b-1cc124a9769a

Do you notice snoring/noisy breathing at night/while your child is sleeping?

  • linkId: b326271b-e9b1-45a0-b899-125364833702
  • Answers: #YesNo

Details

  • linkId: 36a3967c-e79a-49a7-8022-ac9561c4e656
  • Enable When: todo

Hearing concerns

  • linkId: ec7b6e93-e1f0-41f5-b2c2-43c7ddff8aed

Is there anything that you are worried about with your hearing?

  • linkId: 3e53edc7-c90e-4681-a006-b7a05b91a02c
  • Answers: #YesNo

Details

  • linkId: d72dacb8-a9b3-483b-ae24-8b062873b2cb
  • Enable When: todo

Last hearing test (audiology)

  • linkId: 11aa62ca-5a52-428b-952b-cfbcd2c75824

Ear examination

  • linkId: 31452c47-30b2-4590-95f4-b2b75aad2fb6

Otoscopy

  • linkId: 44c3434d-ea52-43bd-b635-34184e5f037d

Video otoscopy procedure recommended where possible as it allows for parental education and for images to be saved for tracking over time

  • Flags: icon
  • linkId: fe96046a-a202-4c22-ad3e-00419e717185

Otoscopy findings

  • linkId: 2841915f-c8d2-4edb-8bc7-39b63385a2fb

Left ear

Right ear

Otoscopy findings

  • linkId: 361b3c80-375b-423e-bb61-5732826bc2f0

Left ear

Right ear

Tympanometry

  • linkId: 972afa06-9649-43d9-b8ce-c802f7f27e39

Left ear

  • linkId: a0d1413f-31e5-4b29-a00b-235f50f91cf7

Right ear

  • linkId: 6423348a-943f-41e5-b4f2-ef5a34e56414

Health priorities, actions and follow-up

  • linkId: ac87b23a-b022-4d62-9e82-1c56583bca34

Mark section as complete

  • linkId: MarkComplete-6

Produced 08 Sep 2023