{"data":{"id":"us-va/18vac30-21-145","jurisdiction":"us-va","citation":"18VAC30-21-145","heading":"Limited cerumen management","body":"A. In order for an audiologist to perform limited cerumen management, he shall:\n\n1. Be a graduate of a doctoral program in audiology that is accredited by the Council on Academic Accreditation of the American Speech-Language-Hearing Association or other accrediting body recognized by the board and that included didactic education and supervised clinical experience in cerumen management as specified in subsection B of this section; or\n\n2. Complete a course or workshop in cerumen management that provides training as specified in subsection B of this section and that is approved by the American Speech-Language Hearing Association or the American Academy of Audiology.\n\nB. An audiologist shall maintain documentation evidencing satisfactory completion of training in cerumen management to include the following:\n\n1. Recognizing the presence of preexisting contraindications that necessitate referral to a physician;\n\n2. Recognizing patient distress and appropriate action to take if complications are encountered;\n\n3. Use of infection control precautions;\n\n4. Procedures for removal of cerumen, including cerumen loop, gentle water irrigation, suction, and the use of material for softening;\n\n5. Observation of each type of cerumen management procedure performed by a qualified audiologist or physician; and\n\n6. Successful performance, under direct supervision by an audiologist qualified to perform cerumen management or a physician, of each type of cerumen management procedure.\n\nC. An audiologist shall not perform cerumen management on a patient who has any of the following preexisting contraindications:\n\n1. A perforated tympanic membrane;\n\n2. Inflammation, tenderness, drainage, or open wounds or traces of blood in the external ear canal;\n\n3. History of ear surgery that results in distortion of the external ear canal;\n\n4. HIV infection or bleeding disorders;\n\n5. Actual or suspected foreign body in the ear, excluding hearing aid components that are located in the lateral one-third portion of the ear canal;\n\n6. Stenosis or bony exostosis of the ear canal; or\n\n7. Cerumen impaction that totally occludes the visualization of the tympanic membrane.\n\nD. An audiologist performing cerumen management shall:\n\n1. Obtain informed consent of the patient or legally responsible adult and document such consent and the procedure performed in the patient record.\n\n2. Refer patients to a physician if they exhibit contraindications or experience any complication, such as dizziness, during the procedure.","path":["Title 18. Professional And Occupational Licensing","Agency 30. Board of Audiology And Speech-Language Pathology","Chapter 21. Regulations Governing Audiology and Speech-Language Pathology","Part V. Standards of Practice"],"source_url":"https://law.lis.virginia.gov/admincode/title18/agency30/chapter21/section145/","current_through":"2026 Regular Session (effective July 1, 2026)","vintage":"","retrieved_at":"2026-09-14T04:52:24Z","sha256":"81193992fde396f37d7ea35faad444f48b73c14569d15d779e39f15077af3f5f","source_id":"us-va-vac","stale":false,"prev":"us-va/18vac30-21-141","next":"us-va/18vac30-21-160"},"notice":"GroundRules: Original legal text. Not legal advice."}