Nucleus Fitting Software 1.2 User Guide
Contents Get started... 4 Symbols used in this guide... 4 Introduction... 5 System requirements... 6 Connect a sound processor... 6 Connect a remote assistant... 6 Access Training Mode... 7 Start a session... 7 Implant checks...8 Work with clients... 9 View existing client details... 9 Add new client... 9 Edit client details... 10 Edit the implant side... 10 Export client details... 10 Import client details... 11 Fit clients... 12 Non auditory stimulation... 12 Create a new hearing profile... 13 Set Master Volume... 14 Set Bass & Treble... 15 Adjust comfort... 16 Adjust thresholds... 16 Limits... 17 Configure processor settings... 18 Configure implant settings... 21 Finalise a session... 22 View usage data... 23 Work with databases...24 Create or edit a connection... 24 Connect to a server... 25 Create a database... 25 Upgrade a database... 26 Back up or restore a database... 26 Delete a database...27 Labelling symbols... 28 Certification, applied standards and copyright information... 28
Get started Get started Symbols used in this guide Note Important information or advice. Can save inconvenience. Tip Time saving hint or saves inconvenience. Caution (no harm) Special care to be taken to ensure safety and effectiveness. Could cause damage to equipment. Warning (harmful) Potential safety hazards and serious adverse reactions. Could cause harm to person. 4 - Nucleus Fitting Software 1.2 User Guide Cochlear Limited 2014
Get started Introduction Nucleus Fitting Software is intended to be used by cochlear implant and hearing care professionals to create and modify hearing profiles in order to provide comfortable and usable stimulation to cochlear implant recipients. The cochlear implant system components compatible with Nucleus Fitting Software are listed below. Cochlear Nucleus Sound Processors CP800 Series Freedom CP900 Series CP802 Sound Processor CP810 Sound Processor Freedom Sound Processor CP910 Sound Processor CP920 Sound Processor Cochlear Nucleus Implants Nucleus CI522 Cochlear Implant Nucleus CI513 Cochlear Implant Nucleus CI512 Cochlear Implant Nucleus CI422 Cochlear Implant Nucleus CI24RE (H) Cochlear Implant Nucleus CI24RE (CA) Cochlear Implant Nucleus CI24RE (ST) Cochlear Implant Nucleus CI24RE (CS) Cochlear Implant Nucleus CI24M Cochlear Implant Nucleus CI24R (ST) Cochlear Implant Nucleus CI24R (CS) Cochlear Implant Nucleus CI24R (CA) Cochlear Implant Cochlear Nucleus Remotes Nucleus CR110 Remote Assistant Nucleus CR120 Intraoperative Remote Assistant Nucleus CR230 Remote Assistant Nucleus CR220 Intraoperative Remote Assistant Note: Nucleus Fitting Software does not support auditory brainstem or double array implant types. Not all products are approved in all markets. Cochlear Limited 2014 Nucleus Fitting Software 1.2 User Guide - 5
Get started System requirements The minimum computer system requirements are listed below: Operating system Windows 8, Windows 7, Windows Vista, Windows XP (32-bit only, Service Pack 3) Processor RAM Hard drive CD-ROM Intel Pentium 4 2.4 GHz 1 GB or greater Screen resolution 1024 x 768 USB port 1 x port USB 1.0 7 GB or greater with at least 6 GB of available space Required for software installation only Any IBM compatible computer system connected to the Cochlear system, when used in programming mode, should meet FCC 47CFR Part 15 Class B and CISPR22 Class B emissions requirements. Consult the documentation provided by the computer system manufacturer to ensure compliance, prior to connecting any Cochlear Limited device. Connect a sound processor Prior to fitting a client s hearing profile through Nucleus Fitting Software, their sound processor must be connected to your computer via a Cochlear Nucleus USB cable (USB cable), a Cochlear Nucleus Programming Pod (Programming Pod) and a Cochlear Nucleus Programming Shoe (Programming Shoe). To connect the devices to your computer: 1. Connect the Programming Pod to your computer with the USB cable. 2. Connect the Programming Shoe to the Programming Pod by aligning the arrow on top of the Programming Shoe cable s round connector to the top of the Programming Pod. 3. Untwist anti-clockwise the battery from the client s sound processor. 4. Twist the Programming Shoe clockwise onto the sound processor. The sound processor is connected to the computer. Connect a remote assistant Nucleus Fitting Software allows you to apply updated software to remote assistants when required. To connect a remote assistant: 1. Connect the remote assistant via a USB cable to the computer on which Nucleus Fitting Software is running. 2. If the software on the connected remote assistant is not supported by the current version of Nucleus Fitting Software, the Update Remote Assistant message displays: Click Update to update the remote assistant software Click Disconnect to close the message without updating the software. 6 - Nucleus Fitting Software 1.2 User Guide Cochlear Limited 2014
Get started Access Training Mode Training mode allows you to become familiar with Nucleus Fitting Software without editing or saving any new data to the client database. To access training mode, click Start Training Mode from the Client screen after you launch Nucleus Fitting Software. The training mode indicator displays in the bottom left of the screen. To end training mode, click End on the training mode indicator. Start a session Each session fits one sound processor at a time. If the client is a bilateral Cochlear implant client, switch off or remove the other sound processor prior to starting the session. The second sound processor may cause interference and should be switched off for the following steps: connecting the implant running AutoNRT adjusting thresholds. At other times the other processor may be switched on. To start a session: 1. Double-click the Nucleus Fitting Software icon on your desktop. 2. Double-click an existing client s name from the client list to access their record. Alternatively, click Add client on the Client screen to add a new client to the database. Note: Follow the instructions on the Client Details screen to connect the device to the computer. 3. Connect the Programming Pod. The programming pod connection status changes to connected when successfully connected. 4. Connect the sound processor you wish to fit during the session to the Programming Pod system. The sound processor connection status changes to connecting while the device information is read. The status changes to connected when successfully connected. 5. Place the coil on the client s head. The coil connection status changes to testing while automatic tests are run, eg. an impedance check, power checks. An impedance check is an implant test that measures the impedance for each electrode and detects any short- or open-circuit electrodes. This testing may take a short time to complete. The status changes to connected when successfully connected. Note: If the implant is not identified in the Cochlear database, the following steps are required. 6. Select the implant side. 7. Enter the date of initial stimulation for the implant. The current date will default, this can be changed if required. Cochlear Limited 2014 Nucleus Fitting Software 1.2 User Guide - 7
Get started 8. Click Save. 9. Click Start Session. If the client has a hearing profile, they will hear ambient sounds through the sound processor microphone and the On Air indicator displays on the screen. Implant checks Before a fitting session can commence, checks are performed to ensure that only implants supported by Nucleus Fitting Software are fitted for the client. Nucleus Fitting Software does not support auditory brainstem or double array implant types. WARNING Do not fit an auditory brainstem implant (ABI) or double array implant with Nucleus Fitting Software. Nucleus Fitting Software does not support these implant types. Fitting an ABI with Nucleus Fitting Software could be harmful to the client. CAUTION Before a fitting session commences, ensure that only implants supported by Nucleus Fitting Software are fitted for the client. The software performs a series of automatic checks when first connected to the implant and a message asking if you are certain of the implant type will appear. If you are not certain of the implant type, click the Disconnect button or contact your Cochlear representative for further information. The following checks take place automatically before the implant is connected: The sound processor is checked to determine if it has previously been programmed by Custom Sound software. If an auditory brainstem or double array implant has been programmed, the implant type will have been recorded. If the implant is an auditory brainstem or double array implant, a message displays stating that the implant is not supported. If the implant type is not known (the sound processor is blank) and Nucleus Fitting Software detects that the implant is a Nucleus 24 implant, the Check implant type message displays. If you are certain that the implant is not an auditory brainstem or double array implant, select the check box to confirm and click the Continue button OR If you are not certain of the implant type, click the Disconnect button. If you are not sure of the implant type, ensure you are certain before fitting the client. Alternatively contact your Cochlear representative for further information. If you continue and the implant is a Nucleus 24 implant, a test is performed on the first electrode. If the first electrode has an open circuit, a message displays stating that fitting cannot continue: "Tests indicate that the connected implant may be an ABI (Auditory Brainstem Implant). Fitting ABI implants with this software could be harmful to the client, so we're unable to start a session without accurately identifying the implant. If available, please import the client s CDX file from a previous fitting session, or refer your client to a clinician using Custom Sound software." Note: If the implant is a Nucleus 24 implant with an open circuit and it has been fitted previously, a CDX file can be imported for the client. This will allow a fitting session to take place if the implant is not an auditory brainstem or double array implant. 8 - Nucleus Fitting Software 1.2 User Guide Cochlear Limited 2014
Work with clients Work with clients The Client screen displays automatically when Nucleus Fitting Software is launched and displays a list of all current clients contained in the client database. The Client screen allows you to: Access training mode View existing client details Add a new client Import client details View existing client details The Client screen displays a list of client information contained in the client database, such as the clients name, date of birth, age, gender and date of the last session. Clients can be sorted by clicking the header of the column you wish to sort by, or filtered using the Search by name field. To access the client notes, device connection status and session history, double-click the client name in the Client screen, or select the client name and click View Client. Add new client The Add Client screen is used to add a new client s personal details to the client database. To add a new client: 1. Click Add & import and select Add new client from the Client screen. 2. Complete the Name fields. 3. Complete the Date of Birth field. 4. Select the Gender of the client. 5. Add client notes, if required. 6. Click Save. Note: If the implant is not identified in the Cochlear database, the following steps are required. 7. Select the implant side. 8. Enter the date of initial stimulation for the implant. The current date will default, this can be changed if required. 9. Click Save. The client details are saved to the client database. Click Start session to begin the fitting session. Cochlear Limited 2014 Nucleus Fitting Software 1.2 User Guide - 9
Work with clients Edit client details The Edit Client screen displays the client name, date of birth, gender and notes. The Edit Client screen enables you to edit existing client details. To edit client details: 1. Click the button and select Edit Client in the Client Details screen. 2. Type the updated client details into the fields. 3. Click Save. The client details are saved to the client database. Edit the implant side If the incorrect side has been selected for the implant, this can be corrected on the Client Details screen. To edit the implant side: 1. Click the button next to the implant symbol. 2. Select the implant side. 3. Enter the date of initial stimulation for the implant. The current date will default, this can be changed if required. 4. Click Save. Export client details A client s details can be exported to a file, which can then be imported into another Nucleus Fitting Software or Custom Sound Suite database. To export a client s details: 1. Double-click to select the client from the Client screen. The Client s Details screen displays. 2. Click the button and select Export Client. The Save As window displays. 3. Navigate to the location you wish to save the exported file. 4. Change the suggested file name if required. 5. Click Save. The client details save to the specified location as a Cochlear Data Exchange (.cdx3) file. 10 - Nucleus Fitting Software 1.2 User Guide Cochlear Limited 2014
Work with clients Import client details Client details can be imported into Nucleus Fitting Software via a cdx file, or directly from the client's sound processor. Import client details from a cdx file: Client files that have been exported from another Nucleus Fitting Software or Custom Sound Suite database can be imported into the Client list. To import a client from a cdx file: 1. Click Add & Import and select Import from CDX filein the Client screen. 2. Navigate to the Cochlear Data Exchange (.cdx,.cdx2 or.cdx3) file you wish to import. 3. Click Open. The file is imported into Nucleus Fitting Software. A new client is created, or, if the client already exists, the current details are merged. Import client details from a sound processor: 1. Connect the processor on the Client details screen. 2. Click Import when the Import message appears. Cochlear Limited 2014 Nucleus Fitting Software 1.2 User Guide - 11
Fit clients Fit clients Nucleus Fitting Software enables you to create hearing profiles and adjust sound for clients. After adding or editing client details, you can start a fitting session from the Adjust hearing profile screen. When an initial activation is being performed, the suggested fitting order is to start with the creation of a new hearing profile, followed by adjustments to the volume. You may then choose to perform some fine tuning, including: bass and treble adjustments comfort measurements threshold measurements or, you can simply finalise the session. Notes can be added in the Session notes field in the Client section of the screen, at any point during the fitting session. These notes will be saved and can be viewed via the Session history option in the Client section of the screen. Subsequent fitting sessions may only require fine tuning adjustments, rather than the creation of a new hearing profile. When the fitting session is in progress the ON AIR indicator will light up. When this indicator is yellow, it means the microphones on the client's sound processor are switched on. If the ON AIR indicator is not yellow, it means that the client's sound processor microphones are turned off and the client will only be able to hear stimulation from the software when setting or checking the different levels. They will not be able to hear you talking to them. To access the Adjust hearing profile screen, click Start session from the Client Details screen. Non auditory stimulation Note: Clients may experience non auditory stimulation during a fitting session, such as facial twitching or tingling. If this occurs, the following steps can be performed using Nucleus Fitting Software: 1. On the Master Volume, Bass & Treble screen, decrease treble and adjust master volume until sound is comfortably loud. 2. If facial twitching or tingling continues, stimulate each band on the Comfort screen to identify which band is causing the symptom. Reduce the level on that band until the facial twitching or tingling is alleviated. 3. If facial twitching or tingling persists: i. Open the Implant Settings screen and disable one electrode from the band identified during stimulation on the Comfort screen. ii. Repeat stimulation on that band on the Comfort screen. iii. iii. Repeat this process until the facial twitching or tingling is alleviated. 4. If you are unable to solve the problem, refer your client to a clinician using Custom Sound software. 12 - Nucleus Fitting Software 1.2 User Guide Cochlear Limited 2014
Fit clients Create a new hearing profile The Create hearing profile screen is used to create a hearing profile for the client based on electrical measurements from the implant. Nucleus Fitting Software measures the response of the auditory nerve to electrical stimulation on five different electrodes through AutoNRT, a patented Cochlear technology. Nucleus Fitting Software automatically searches for the neural response threshold by increasing the stimulation level progressively. The AutoNRT process is optional, not mandatory; you can also create a hearing profile using the average hearing profile. If you use AutoNRT, as the five measurements are taken, several beeps with increasing loudness can be heard, starting at very soft levels and increasing to loud sounds. It is normal that at times the sound may be very loud. AutoNRT will automatically move to the next stage or measurement when the result is found and a progress update will be displayed. Before creating the hearing profile, explain to the client that they will go off-air and will not be able to hear your voice. The client will only hear the stimulation from the software. The client should not be concerned if they cannot hear any sounds, although some sounds may be quite loud. If any sounds are uncomfortably loud you can stop the test at any time. There is a small proportion of clients who will not demonstrate the expected response from AutoNRT and will not be able to complete a hearing profile using AutoNRT. This can happen for a number of reasons, eg. the auditory nerve is still adjusting to electrical stimulation. If AutoNRT cannot be completed, the hearing profile can be created using the average hearing profile. If the AutoNRT process is cancelled, the hearing profile will also be created using the average hearing profile. There are two ways to access the Create hearing profile screen: For an existing client, click Reset Profile in the Adjust hearing profile screen. If the hearing profile is being reset, a message will ask you to confirm that you want to continue. You may need to advise your client that the new profile will sound different. For a new client, click Start Session in the Client Details screen. If the client is bilateral, ensure their other sound processor is switched off before creating the hearing profile. Note: AutoNRT is not available for Nucleus 24 implants and will not be performed. When creating a new hearing profile for clients with a Nucleus 24 implant you will be automatically directed to the Master volume, bass & treble screen. These clients will be given an average hearing profile. To create a new hearing profile using AutoNRT: 1. Click Start to initiate the automatic process. The corresponding rising progress bar will indicate the progression through the series of beeps presented to the client on each electrode. With each successful measurement, the five sections of the progress wheel will change from yellow to green. The process of creating a hearing profile may take several minutes to complete. Note: If the client describes the beeps as uncomfortably loud, click Pause to skip this phase of the process. The software will automatically move to the next electrode in the AutoNRT sequence. If you skip three times in a row, AutoNRT will automatically cancel and the client s hearing profile will be based on the population mean. Note: To stop the process at any time, press the Escape key on the keyboard. This will stop all stimulation for the client. Cochlear Limited 2014 Nucleus Fitting Software 1.2 User Guide - 13
Fit clients 2. You may wish to ask the client to point to the loudness scale to provide feedback on the volume of the sounds they are hearing. 3. Once the hearing profile is complete, click Continue to proceed to the Master Volume, Bass & Treble screen. The initial hearing profile is created at a very low volume and the client will not be able to hear when the automatic measurements are complete. You will always need to increase the Master Volume after completing the hearing profile. If three or more successful measurements are taken, the new hearing profile will be based on those measurements. If three successful measurements are not completed, the hearing profile will be created using the average hearing profile. Set Master Volume Master Volume is set using live speech until sounds are comfortably loud for the client. The master volume adjustment control enables you to adjust the overall loudness of all sounds heard by your client. The client will hear a beep each time the master volume level is adjusted. Adjustments to the master volume will always be required after creating an initial hearing profile. If the master volume is being adjusted following the creation of a new hearing profile, the client will not be able to hear any sound until adjustments have been made. When creating a new hearing profile or resetting a hearing profile for a client, the master volume scale displays the expected range of volume at the top of the scale. The expected range of volume is based on the client s AutoNRT data (or the population mean if AutoNRT was not successfully completed). The expected range is a guide only, and in some instances, the client s volume may be outside this range. The current master volume is indicated in green on the master volume scale and the current level (CL) is displayed beside the bar. The current level is the amount of current that is being used to stimulate the auditory nerve. A dotted line across the bar shows the starting CL. Adjustments should be made by gradually increasing the master volume level and talking to the client until they can hear sounds at a loud & comfortable level. The client will hear 'beeps' when adjustments are made and they will also be on-air, so you should interact with them during this process. Ensure your voice is at normal conversation volume when you talk to the client. There are two ways to access the Master Volume, Bass & Treble screen: Continue from the Create hearing profile screen Click Master Volume, Bass & Treble from the Adjust Profile screen. To adjust the Master Volume: 1. Click the button or the button on the Adjustment control to set the loudness for the client. The client will hear a beep when the level is adjusted. Tip: Hold down Shift on the keyboard when clicking the level is being adjusted downwards. button to cancel the beeps when the 2. Click the button in the centre of the Adjustment control to play a beep at the current volume, to confirm the client s accepted comfort level without changing it. 3. Talk to your client at normal conversation volume to check that the volume is loud & comfortable. 14 - Nucleus Fitting Software 1.2 User Guide Cochlear Limited 2014
Fit clients 4. You may wish to ask the client to point to the loudness scale to provide feedback on the volume of the sounds they are hearing. 5. Click Save after completing all adjustments. Note: Click the switch below the Master Volume Adjustment control to change the volume in increments of two or four current levels per click. Note: Click Cancel to cancel any changes you have made before saving. Note: Ensure you also check the client's comfort level with loud sounds, eg. clapping or speaking loudly. Set Bass & Treble Bass & Treble is set to adjust sound quality using live speech. The bass adjustment control allows you to increase or decrease the volume of low pitched or deep sounds. The treble adjustment control increases or decreases the volume of high pitched sounds. The client will hear a beep each time the bass or treble levels are adjusted. Adjustments to bass and treble can be performed during the client's initial session, or these adjustments may be performed during a follow up session. Adjustments should be made by gradually increasing or decreasing the levels and talking to the client until bass & treble sounds are at a loud & comfortable level. The client will hear 'beeps' when adjustments are made and they will also be on-air, so you should interact with them during this process. Ensure you talk to the client with your voice at normal conversation volume. There are two ways to access the Master Volume, Bass & Treble screen: Continue from the Create hearing profile screen Click Master Volume, Bass & Treble from the Adjust Profile screen. To adjust Bass or Treble: 1. Click the button or the button on the Adjustment control to set the loudness of bass or treble sounds for the client. The client will hear a beep when the level is adjusted. Tip: Hold down Shift on the keyboard when clicking the level is being adjusted downwards. button to cancel the beeps when the 2. Click the button in the centre of the Adjustment control to play a beep at the current level, to confirm the client s accepted comfort level without changing it. 3. Talk to your client at normal conversation volume to check that the level is loud & comfortable. 4. You may wish to ask the client to point to the loudness scale to provide feedback on the volume of the sounds they are hearing. 5. Click Save after completing all adjustments. Note: Click Cancel to cancel any changes you have made before saving. Note: Ensure you also check the client's comfort level with loud sounds, eg. clapping or speaking loudly. Cochlear Limited 2014 Nucleus Fitting Software 1.2 User Guide - 15
Fit clients Adjust comfort The Comfort screen is used to check that all sounds are comfortably loud for the client. The objective is to alleviate any discomfort the client might report with certain loud sounds. Comfort is checked by playing eight different sounds evenly spaced in bands across the implant. To check that all eight bands are comfortably loud, a sweep across all bands plays a scale of beeps to the client. If the client indicates a band is too loud, you can adjust the loudness for that particular band. In addition, the loudness of different bands can be balanced to alleviate any sound quality issues. If on the first sweep the client does not report any sounds that are uncomfortably loud and there are no signs of non auditory stimulation, eg. facial nerve stimulation, then no adjustments are required. To access the Comfort screen, click Comfort from the Adjust Hearing Profile screen. To check comfort levels: 1. Click Sweep to sequentially generate sound across the implant. 2. You may wish to ask the client to point to the loudness scale to provide feedback on the volume of the sounds they are hearing. 3. If the client indicates that one of the bands is too soft or too loud, click the band control at any time to stop the sweep. 4. To adjust the loudness for each band: Click the button or the button on the Adjustment control to set the loudness of the beep presented to the client. The client will hear a beep when the level is adjusted. To confirm the client s accepted comfort level without changing it, click the centre of the Adjustment control to play a beep at the current volume. button in the Tip: Hold down Shift on the keyboard when clicking the level is being adjusted downwards. button to cancel the beeps when the 5. After making any adjustments, you may need to perform another sweep to confirm the adjustments are suitable. 6. Click Save to save the changes to the profile. Note: Click Cancel to cancel any changes you have made before saving. Adjust thresholds The Thresholds screen is used to adjust the threshold measurements for clients who have difficulty hearing the quietest sounds, or are hearing constant background noise. The threshold levels for three evenly distributed electrodes along the cochlear implant can be adjusted. When you access the Thresholds screen, the client will initially be on-air and will be able to hear you provide instructions. However, when you click any of the buttons on the Thresholds screen, the client will immediately go off-air. Ensure you provide the client with instructions before making any adjustments. Adjust each level to the point where the client can just hear the sound produced by the software. Ensure the client cannot see you click the mouse and is not receiving any visual cues as you make each adjustment. Consider varying the time between each adjustment, or clicking the mouse while not making any adjustments. To access the Thresholds screen, click Thresholds from the Adjust Hearing Profile screen. 16 - Nucleus Fitting Software 1.2 User Guide Cochlear Limited 2014
Fit clients To adjust the low, medium and high threshold levels to the point where the client can just hear the softest sounds: 1. If a beep is audible, click the button until the beep is only just audible. Tip: Hold down Shift on the keyboard when clicking the level is being adjusted downwards. button to cancel the beeps when the 2. If the client indicates they cannot hear the beep, click the button until it is just audible. 3. To confirm the client s threshold level without changing it, click the button to play a beep at the current level. 4. You may wish to ask the client to point to the loudness scale to provide feedback on the loudness of the sounds they are hearing. Note: When the client can hear the sound, you may want to reconfirm the measurement by reducing the level and then increasing it by an increment of 2 until you can find the exact point where they can just hear the sound. 5. Click Test (on air). 6. Confirm that the level of soft sounds has improved for the client. 7. Adjust the settings and test on air again if required. 8. Click Save when satisfied with all three levels. Note: Click Cancel to cancel any changes you have made before saving. Limits Limits may be reached when adjusting levels in Nucleus Fitting Software, eg. Master Volume, Thresholds. These limits are in place to ensure the battery has the ability to achieve the desired loudness and provide power to the sound processor. Limits will vary per client, and depend on factors including the type of implant and the client's skin flap thickness. If a limit is reached, a message will display and the following options are available to you: make no further changes to the setting that has reached it's power limit change the power settings to allow greater loudness for the client refer the client to a Custom Sound software clinician for further adjustments. The following steps will take place if you click Continue on the message dialogue: the client will be taken off air Master Volume will be reduced and sounds will be quieter for the client power settings will be re-calculated the client will be put back on air. This process will take a short time to complete. Once complete, it will then be necessary to adjust Master Volume. You may also need to adjust Thresholds if they have been measured previously. Cochlear Limited 2014 Nucleus Fitting Software 1.2 User Guide - 17
Fit clients Configure processor settings The Processor Settings screen is used to review and edit a client s sound processor settings during any stage of the session. To access the Processor Settings screen, click the Processor Settings button, e.g. in the status bar. Note: The name of the button will vary depending on the sound processor being used. To edit the processor settings: 1. Select or clear the checkboxes for the specific settings to activate or deactivate a desired setting. Some settings will have options that can be selected on a drop-down menu. 2. Click Save to save the changes and close the screen. Note: Click Cancel to cancel any changes you have made before saving. CP800 Series and Freedom Sound Processor settings Processor configuration Client-adjustable settings Telecoil mixing ratio: specifies the ratio of the telecoil input in relation to the microphone input. Accessory mixing ratio: specifies the ratio of the accessory input in relation to the microphone input. Indicator light: sound: displays a light on the sound processor to indicate an incoming audio signal is being received. Indicator light: key presses & alerts: displays a light on the sound processor when a warning is signalled or a key is pressed on the sound processor or remote assistant. Private tones: delivers a tone only audible to the client when a warning is signalled or a key is pressed on the sound processor or remote assistant. Clinician-adjustable settings Allow telecoil: allows the Telecoil to be turned on or off by the client using the sound processor or the remote assistant. Allow auto telecoil: allows the sound processor to automatically activate the telecoil in response to an incoming signal. When selected, Auto Telecoil can be turned on or off by the client using the remote assistant. Auto sound processor off: enables the sound processor to turn off automatically when the coil is off the implant for more than two minutes. Allow volume control: enables the volume to be adjusted using the controls on the remote assistant. CP800 Series Sound Processors Freedom Sound Processor 18 - Nucleus Fitting Software 1.2 User Guide Cochlear Limited 2014
Fit clients Allow hearing profile adjustments: enables the hearing profile to be adjusted using the remote assistant. Allow creation of new hearing profile:enables a new hearing profile to be created using the remote assistant. Telecoil always on (program 4): specifies that the telecoil is always on when program 4 is selected. Telecoil mixing ratio: specifies the ratio of the telecoil input in relation to the microphone input. Accessory mixing ration: specifies the ration of the accessory input in relation to the microphone input. Indicator light: sound: displays a light on the sound processor to indicate an incoming audio signal is being received. Indicator light: key presses & alerts: displays a light on the sound processor when a warning is signalled or a key is pressed on the sound processor or remote assistant. The light is only applicable when the coil is on the implant. Sound processor volume control: enables the volume to be adjusted using the controls on the sound processor. When cleared, the volume cannot be adjusted by the recipient. Public key press notification: delivers a public tone when a key is pressed on the sound processor. Private key press notification: delivers a private tone when a key is pressed on the sound processor. Public tones: delivers a public tone when a warning is signalled. Private tones: delivers a tone only audible to the client when a warning is signalled or a key is pressed on the sound processor or remote assistant. Cochlear Limited 2014 Nucleus Fitting Software 1.2 User Guide - 19
Fit clients CP900 Series Sound Processor settings Processor configuration Client-adjustable settings Telecoil mixing ratio: specifies the ratio of the telecoil input in relation to the microphone input. Processor lights: displays a light on the sound processor to indicate functionality or fault conditions. The options available in the list are: Child - indicator lights are displayed for microphone input, auxiliary input, alarms and processor auto-off when the sound processor is on or off the recipient's head. Monitor - indicator lights are displayed for auxiliary input when the sound processor is off the recipient's head, alarms and processor auto-off. Adult - indicator lights are displayed for alarms when the sound processor is off the recipient's head and processor autooff. Processor beeps: delivers a tone only audible to the client when a warning is signalled or a key is pressed on the sound processor or remote assistant. CP910 Sound Processor CP920 Sound Processor Note: Clients can change these settings at any time using the remote assistant. Clinician-adjustable settings Allow telecoil: allows the Telecoil to be turned on or off by the client using the sound processor or the remote assistant. Allow auto telecoil: allows the sound processor to automatically activate the telecoil in response to an incoming signal. When selected, Auto Telecoil can be turned on or off by the client using the remote assistant. Auto processor off: enables the sound processor to turn off automatically when the coil is off the implant for more than two minutes. Remote assistant settings Allow volume control: enables the volume to be adjusted using the controls on the remote assistant. Allow hearing profile adjustments: enables the hearing profile to be adjusted using the remote assistant. 20 - Nucleus Fitting Software 1.2 User Guide Cochlear Limited 2014
Fit clients Configure implant settings The Implant settings screen is used to display the state of implant electrodes and to manually turn an individual implant electrode on or off. An implant electrode will display one of three states on the Implant settings screen: On the default state, may be turned off by clicking the electrode Off can be turned on by clicking the electrode Automatically turned off, and cannot be turned on. An electrode will display as automatically turned off if it has been flagged during an impedance check. An impedance check is an implant test that measures the impedance for each electrode and detects any short- or open-circuit electrodes. An impedance check is performed automatically at the start of a fitting session while the implant is connecting to Nucleus Fitting Software. Electrodes that have been turned off automatically are retested when an impedance test is next performed. The 22 electrodes are arranged in eight groups, called bands. When all electrodes in one band are turned off, the whole band will be unavailable in the Comfort screen. Electrodes that are turned off are not used when adjusting a hearing profile. The client can be fitted using Nucleus Fitting Software when twelve or more electrodes are available. The frequencies will be reallocated amongst the remaining available electrodes. However, if less than twelve electrodes are available, refer to a clinician using Custom Sound software as you will not be able to use Nucleus Fitting Software. To access the Implant Settings screen, click the Implant button in the status bar at the top right hand side of the session home screen. To turn an individual electrode on or off: 1. Click the desired Electrode button to activate or deactivate the electrode. 2. Click Save to save the changes and close the screen. Note: Click Cancel to cancel any changes you have made before saving. Cochlear Limited 2014 Nucleus Fitting Software 1.2 User Guide - 21
Fit clients Finalise a session The Finalize session screen is used to write the new or adjusted hearing profile and settings to the sound processor. It also includes tips about environments and battery suitability to aid discussion with the client during the client counselling session. There are four environments available for CP800 series and Freedom sound processors: Everyday Noise Focus Music. The client may need to change their environment to suit different situations. There are two environments available for CP900 series sound processors: SCAN Program 2. The SCAN environment automatically classifies the listening environment and selects the most appropriate technologies to give your client the best possible hearing outcomes. The Program 2 environment is less adaptive and may be preferred by some clients in certain listening environments. Environments can be configured further if required, by a Clinician using Custom Sound software. Before finalising the session with the client you may wish to explain that their volume will automatically be set to 6 every time they present for a fitting session. This allows the client to adjust their volume both upwards and downwards via their sound processor or remote assistant. If the client adjusts the volume themselves you may notice that the Master Volume level in Nucleus Fitting Software has changed to automatically compensate for the client's volume adjustment. The Finalize session screen displays after clicking Finalize session from the Adjust hearing profile screen. To finalise the fitting session: 1. Counsel the client on the environments they will have saved to their sound processor. 2. Click Write to sound processor. 3. Select the Battery Suitability tab. 4. Counsel the client on the best battery suitability for their profile. The Battery Suitability tab will suggest the most suitable batteries and the estimated battery life according to the client's hearing profile. 5. Click Save & end session. 22 - Nucleus Fitting Software 1.2 User Guide Cochlear Limited 2014
View usage data View usage data Usage data is available for clients with CP900 Series sound processors. To access the Data viewer: Click the button and select 'View usage data'. The data viewer opens in a new screen and displays pie charts showing daily averages for Time on Air, Scenes and Program usage. Note: For a bilateral recipient two sets of data will be displayed. To view Loudness data, click on the Show button Loudness data will display. to the left of the Scenes graph and select Loudness. The To view Accessory usage, click on the Show button to the left of the Program usage graph and select Accessory usage. The Accessory usage data will display. Trend graphs: For Time on Air, Scenes and Loudness, a trend graph is displayed under the pie chart display data for the last 5 periods. If the mouse is rolled over each of these graphs, they will display the length of each period in days. Note: Each period corresponds to the dates the sound processor is connected to Nucleus Fitting Software. Volume or Sensitivity can be selected by moving the rollover switch under the Program usage pie chart. This controls whether volume or sensitivity information is shown when the mouse is rolled over the chart. Accessory Usage: If the mouse is rolled over the Accessory usage pie chart, the number of uses of each accessory during the last period is displayed Note: The sound processor does not need to be connected to see previous periods. Up to five periods are shown in the Data viewer. Cochlear Limited 2014 Nucleus Fitting Software 1.2 User Guide - 23
Work with databases Work with databases A database is automatically created when Nucleus Fitting Software or Custom Sound Suite is first installed. The database is shared across Nucleus Fitting Software, Custom Sound software and Custom Sound EP software, and contains the records for all clients created in all applications. The Cochlear Database Manager allows you to manage databases and to select the database you wish to connect to. You do not need to have Custom Sound Suite installed to use Nucleus Fitting Software, however, if they are installed on your computer, the database will be combined. To access the Cochlear Database Manager, navigate to the Windows Start menu > All Programs > Cochlear > Nucleus Fitting Software and select Cochlear Database Manager. The Cochlear Database Manager contains the following tabs: Connections: displays the list of connections to existing databases. When you log on to Nucleus Fitting Software, Custom Sound software or Custom Sound EP software, the software connects to the database specified by the current connection. The connection that is currently in use is indicated by a Check symbol. Databases: displays the list of existing databases. The Databases tab allows you to connect to the database server, create new databases and manage existing databases. Create or edit a connection The Cochlear Database Manager allows you to create a new connection to an existing database, and to edit or delete existing connections. To create a connection: 1. Click Add in the Connections tab. The Add Connection window displays. Mandatory fields are indicated by a Required symbol. 2. Type a name for the connection in the Connection Name field. 3. Type the name of the server on which the database resides in the Server\Instance Name field. 4. If a password is required to log on to the database server, select the Use a Specific Username and Password option button and type the username and password in the appropriate fields. Otherwise, retain the Use Windows Integrated Security option button. 5. Select the database you wish to connect to from the Database drop-down list. 6. To adjust the amount of time that the software will wait for a response from the database server, type the number of seconds in the Connection Timeout field. 7. Click OK. The connection is added to the Connections list. 8. To select the new connection as the default, right-click on the connection and select Set as Active Connection. The connection is marked with a Check symbol. To edit a connection, right-click on the connection and select Edit Connection. Edit the existing details as required, and click OK. To delete a connection, right-click on the connection, select Delete Connection and click Yes to confirm the deletion. Deleting a connection does not delete the database it connects to. 24 - Nucleus Fitting Software 1.2 User Guide Cochlear Limited 2014
Work with databases Connect to a server In order to create or manage databases, you must first connect to the server on which the databases reside. To connect to a server: 1. Click the Databases tab in the Cochlear Database Manager. 2. Click Connect. The Connect window displays. 3. Type the name of the server on which the databases reside in the Server\Instance Name field, or retain the default setting. 4. If a password is required to log on to the database server, select the Use a Specific Username and Password option button and type the username and password in the appropriate fields. Otherwise, retain the Use Windows Integrated Security option button. 5. Click OK to save the changes and close the Connect window. The databases that exist on the server display in the Database list. Once the connection to the server has been established, the Cochlear Database Manager allows you to: Create a new database Upgrade an existing database Back up or restore an existing database Delete an existing database Create a database The Cochlear Database Manager allows you to create a new database as desired. By default, a connection to the new database is automatically created, but is not selected as the default connection. To create a database: 1. Click Create in the Databases tab. The Create Database window displays. 2. Type a name for the database in the Database field. 3. Type the clinic and clinician names in the appropriate fields. The clinician name is used to automatically create a clinician with clinic administrator rights in the software. 4. Type a name for the connection in the Connection Name field. 5. Retain the Use Windows Integrated Security option button. Alternatively, select the Use a Specific Username and Password option button and type the username and password for the database server in the appropriate fields. 6. Click Create. The database displays in the Database list, and a connection is created in the Connections tab. Cochlear Limited 2014 Nucleus Fitting Software 1.2 User Guide - 25
Work with databases If you do not wish to automatically create a new connection when the database is created, clear the Create a New Connection for This Database check box. Upgrade a database An existing database may need to be upgraded when a new version of the software is released. By default, the Cochlear Database Manager backs up the existing database prior to performing the upgrade. To upgrade a database: 1. Select the database in the Database list. 2. Click Upgrade. 3. Type a file location and filename for the backup file, or retain the default file path. 4. Click Upgrade. The database is upgraded. If you do not wish to back up the database prior to upgrading, clear the Backup the Database Before Upgrading check box. Back up or restore a database The Cochlear Database Manager allows you to back up a database to an external file. A database can be restored from a previous backup if required. To back up a database: 1. Select the database in the Database list. 2. Click Backup. Alternatively, right-click on the database and click Backup. 3. Type a file location and filename for the backup file, or retain the default file path. 4. Click Backup. A backup of the database is saved to the specified location. To restore a database: 1. Click Restore in the Databases tab. 2. Type a new name for the database in the Database field. 3. Type the file path of the file you wish to restore in the Backup File field. Alternatively, click Browse, navigate to the desired file, and click OK. 4. Click Restore. The restored database displays in the Database list. 26 - Nucleus Fitting Software 1.2 User Guide Cochlear Limited 2014
Work with databases Delete a database Databases that are no longer required can be deleted from the Database list. A deleted database cannot be restored. A database can only be restored from a backup file, and it is recommended you back up the database prior to deletion. To delete a database: 1. Select the database you wish to delete in the Database list. 2. Click Delete. Alternatively, right-click on the database and select Delete Database. 3. Click Yes to confirm the deletion. Cochlear Limited 2014 Nucleus Fitting Software 1.2 User Guide - 27
Labelling symbols Labelling symbols The following symbols may appear on the product packaging. Symbol Description Manufacturer. Date of manufacture. Authorised representative in the European Community. Refer to instruction manual Specific warnings or precautions associated with the device, which are not otherwise found on the label CE mark approved by notified body 0197 Certification, applied standards and copyright information The Nucleus Fitting Software fulfils the essential requirements listed in Annex 1 of the EC Directive 90/385/EEC on Active Implantable Medical Devices. The year in which authorisation to affix the CE mark was granted was: 2009: System 4 and System 5 2013: System 6 2013: Nucleus Fitting Software The statements made in this version of the Help are believed to be true and correct as of the date of publication. However, specifications are subject to change without notice. Copyright 2013 Cochlear Ltd. All rights reserved. Cochlear, the elliptical logo, Nucleus, AutoNRT, Freedom, Hear now. And always, mycochlear and Custom Sound are trademarks of Cochlear Limited. IBM is a registered trademark of IBM Corporation. Python Version 2.7.1. Copyright 2001-2012. Python Software Foundation. All rights reserved. Suds Version 0.4 Licensed under the GNU Lesser General Public License. Microsoft, Windows and Windows Vista are registered trademarks of Microsoft Corporation. Intel and Pentium are registered trademarks of Intel Corporation. 28 - Nucleus Fitting Software 1.2 User Guide Cochlear Limited 2014
Cochlear Limited 2014 Printed in Australia 480665 ISS1 JAN 2014