a(a) The course provides at least 6 hours of instruction. b(b) The subject matter of the course relates to removal of cerumen from the ear canal using safe techniques. c(c) The course must include a final practical examination on proper cerumen management procedures. d(d) The course is one of the following: 11. Sponsored or recognized by a local, state, regional, national, or international association of hearing instrument specialists or audiology. 22. A course preapproved by the Board or its designee as sufficient.
(2) In place of a course that satisfies the requirements under sub (1), an applicant may submit evidence of completion of approved practical or occupational training, with a licensed supervising otolaryngologist or licensed audiologist, in cerumen management that has been approved by the board. Approved practical or occupational training in cerumen management shall be at least 6 hours in duration and include practical training in proper cerumen management procedures.
Note: Requests for board approval of practical or occupational training in cerumen management may be sent to the department of safety and professional services at dsps@wi.gov or 4822 Madison Yards Way Madison, WI 53705. (3) For the duration of their cerumen management certification, an individual shall complete at least two of the 20 hours required under s. HAS 8.03 on the topic of diseases of the ear or a similar topic approved by the board. HAS 9.04 Referrals. (1) An individual certified to perform cerumen management shall refer a patient to an otolaryngologist or licensed physician for cerumen management when the patient presents with any of the following:
a(a) Is less than 18 years of age. b(b) A perforated tympanic membrane. c(c) History of pain, active drainage, or bleeding from the ear. d(d) Evidence of congenital or traumatic deformity of the ear. e(e) On anticoagulant therapy. f(f) Are immunocompromised. g(g) Have Diabetes mellitus. h(h) History of prior radiation therapy to the head and neck. i(i) History of ear canal stenosis or exostoses. j(j) A nonintact tympanic membrane. k(k) Ear surgery within the last six months. l(l) Tympanostomy tubes, such that irrigation should not be used. m(m) A bleeding disorder. n(n) Actual or suspected foreign body in the ear. o(o) Stenosis or bony exostosis of the ear canal. p(p) Cerumen impaction that totally occludes the ear canal. q(q) Cerumen located medial to the cartilaginous external auditory canal or beyond the second bend. r(r) A tympanic membrane that the certified individual is unable to see. (2) The certified individual shall immediately stop the procedure and refer a patient to an otolaryngologist or a licensed physician if any of the following occur while performing cerumen management:
(a) Significant pain.
(b) Uncontrolled bleeding.
(c) Laceration of the external auditory canal.
(d) Acute onset of dizziness or vertigo.
(e) Sudden hearing loss.
HAS 9.05 Infection Control. An individual certified to perform cerumen management under this chapter shall establish a written protocol to comply with all of the following infection control procedures:
1(1) Standard precautions for all health care providers. 2(2) Cleaning, disinfection, and sterilization based on manufacturer instructions, where appropriate, of multiple use equipment. 3(3) Universal precautions for prevention of the transmission of human immunodeficiency virus, hepatitis B virus, and other blood borne pathogens as defined by the occupational safety and health standards in 29 CFR 1910.1030. HAS 9.06 Malpractice Liability Coverage. An individual applying for cerumen management certification shall obtain and maintain malpractice liability insurance for the duration of their certification. The insurance policy shall provide professional liability coverage of at least $1,000,000 for each incident or claim.
Section 8. Effective date. The rules adopted in this order shall take effect on the first day of the month following publication in the Wisconsin Administrative Register, pursuant to s. 227.22 (2) (intro.), Stats. ------------------------------------------------------------------------------------------------------------
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