The Army Hearing Program: Supporting the Soldier from Training to Combat

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The Army Hearing ProgramSupporting the Soldier
from Training to Combat

• National Hearing Conservation Association
• Orlando, FL
• February 2010
• COL Vickie Tuten
• CPT(P) Jillyen Curry-Mathis
• CPT Kara Cave

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Briefing Outline
PURPOSE Provide an overview of the Army
Hearing Program, its impact on the Warrior in
training and the role of the deployed Audiologist

1. Introduction to the Army Hearing Program
2. Training Warriors for Combat
3. Proposed Best Practices Initiative
4. Early Roles of the Deployed Audiologist
5. Relocation of Theater Assets
6. Evolution of Role in New Setting
7. Future Directions for the Army Hearing Program
8. Conclusion

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The Army Hearing Program

• Brief Overview

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Army Hearing Program

• The Army Hearing Program (AHP) is a new
  initiative from Office of The Surgeon General
  aimed at improving communication abilities on the
  battlefield and decreasing the rate of
  noise-induced hearing loss among soldiers. There
  are four elements to the AHP IAW Special Text
  (ST) Document 4-02.501, which was implemented in
  February 2008

Hearing Readiness
Hearing Conservation
Clinical Hearing Services
Operational Hearing Svcs
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Answering the Challenges of CombatWhats Changed?
Hearing Conservation Army Hearing Program
Seven Elements Four Components
Hearing Protectors Health Education 1) Hearing Readiness
Monitoring Audiometry 2) Clinical Services
Missing Piece 3) Operational Services
Noise Hazard Identification Engineering Controls 4) Hearing Conservation
Enforcement Program Evaluation Bonus Command Emphasis
Traditionally Garrison-Based Bridges the Gap Garrison Theater
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Training Warriors for Combat

• From Basic Combat Training (BCT)
• to Deployment

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Hearing Readiness

• Hearing Readiness implies that Soldiers have the
  required hearing capabilities, personal
  protective equipment (PPE), and medical equipment
  that are needed to train and deploy.

• Hearing Tests
• Pre-Basic Combat Training Hearing Evaluations
• Annual, Pre/Post-deployment Hearing Tests
• Personal Protection
• Pre-Range Pre-Deployment Hearing Protection
  Fittings
• Regular Range Support for Soldiers
• Required Wear of Earplug Carrying Case on
  Uniform
• Installation Requirement
• Moving to Army-wide Requirement

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Hearing Readiness

• Personal Protection
• TRADOC Doctrine Change Best Practices
  Initiative
• Combat Arms Earplug (CAE) Fittings on all Basic
  Training Soldiers
• Fittings will no longer be completed at reception
  during in-processing
• Combined Operational Hearing Briefing CAE
  Fittings within 2-3 days of Range Training
• Units will be required to contact Army Hearing
  Program to Schedule Class
• Required Wear of Earplug Carrying Case on
  Uniform
• Cadre/Permanent Party Soldiers wear case/earplugs
  on front right belt loop of ACU trousers
• IET Soldiers wear case/earplugs in left-arm
  pocket (non-flag arm)
• Easy check of uniform using right hand taps
• Reinforce transfer of pocket contents when
  changing uniforms
• Prevents loss during drills and corrective actions

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Clinical Hearing Services

• Clinical Hearing Services are required in both
  garrison and deployed settings. Although there
  is some overlap, the variance in services
  delivered between these two environments is
  operationally driven.
• The AHP evaluates all Soldiers failing hearing
  tests
• Hearing Waivers of Recruits converted to Profiles
  describes impact of loss on Soldiers
  performance to Basic Training and Future
  Leadership (Safety Issue)
• H2/H3 Profiles Soldiers obtain profiles to
  determine deployable status and to describe
  impact on performance of mission to leadership
• Rehabilitative Services
• Hearing Aids
• Protective Equipment Combat Arms Earplugs,
  Tactical Communication Protective Systems
  (TCAPS), etc.
• Medical Services for Treatable Hearing Loss

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Hearing Conservation

• The Hearing Conservation Program (HCP) is
  designed to protect Civilian and Military
  personnel from hearing loss due to occupational
  noise exposure. The essential elements of the
  occupational HCP include the seven essential
  elements outlined in the original Army Hearing
  Conservation regulations..

AHP Oversight with support from Preventive Med
Assets
Noise Hazard Identification - Industrial
Hygiene Hearing Protectors - Occupational
Health Monitoring Audiometry - Occupational
Health Hearing Education Courses - Army Hearing
Program
MOS Mechanic School
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Operational Hearing Services

• Hearing injury prevention and communication
  enhancement services delivered to the Solider in
  every environment with the primary objective of
  enhancing survivability and lethality. Services
  include use of TCAPS, noise surveillance, and
  injury prevention.
• Required Annual Introductory Education Courses
• Integrate within Basic Combat Training Courses
  Formal/Informal
• Classes and Fittings can be done in almost any
  environment, easiest is classroom
• Critical for class to be within days of ranges to
  minimize loss and maintain relevancy
• Drill Sergeants will be reinforcing correct
  use/wear of earplugs with BCT Soldiers
• Annual courses for Cadre
• Range and Field Exercises with TCAPS
• Variety of ranges BRM, urban warfare, convoy
  ops
• Different TCAPS systems for different needs
• Noise Abatement Surveys

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Roles of the Deployed Audiologist

• Evolution of Roles in Theater

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Historical Role of Theater Audiologist
Theater Consultant for Iraq Area of Operations
(AO)

• Full diagnostic evaluations including
• Fitness-for-duty/Profiles
• Hearing Aid Selection and Fitting
• Acoustic Trauma
• Dizziness
• Evacuation to Higher Echelons

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Historical Role (contd)

• Guide Theater Policy
• Oversee Data from 8 Pure Tone Testing Sites
• Teach CAOHC Classes
• Promote Hearing Readiness

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Handover Move from Level III to Level II
Baghdad, International Zone
Joint Base Balad
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New Opportunities

• Average Encounters
• 157/month OCT 06-07
• 125/month NOV 07-08
• 85/mo DEC 08-OCT 09
• Garrison 74/month
• JBB home to 20,000 Service Members
• Co-located with ENT
• Clinic Doubled as Classroom
• Co-located with Preventive Medicine Detachment
• Conduct noise surveillance throughout theater
• Access to More Patients and More Noise!

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100.9 dBA
Closer to the Culprit!
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Preventive Medicine Detachment Audiology
332nd supports with equipment
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Lessons Learned
Fueler 98.6 TWA

• Annual testing allowed monitoring even in
  theater.
• Tracking of unit trends
• Identification of patients meant monitoring of
  area
• Hands-on noise surveillance allowed for more
  specific recommendations
• Synergy between noise measurers and
  interpretation expanded services throughout Iraq
• Great opportunity for education, motivated
  audience

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Future Directions

• Detachment Great Model for Audiology to Follow
• Independent Unit, Increase Mobility
• Coordination
• If Services Available, They Will Use It!
• Systematic Means for Prevention Definitely Needed
• Bring Services to the Soldiers, Dont Wait for
  Them to Come to You
• Not All Pre-deployment Services Created Equal,
  Need Services in Theater

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Conclusions

• Components of the Army Hearing Program Translate
  Well to Theater
• AHP Components Require Support in Theater
• Hearing Readiness
• Clinical Services
• Operational Hearing Services
• Challenges Include Getting Audiologist into
  Theater
• Other AOC Models Exist to Imitate (i.e. ESEO)
• 72C Roles Must Vary to Meet Different Operational
  Needs