Precautions

Learn about the following precautions that should be taken for individuals with cochlear implants.

Head Trauma
Discharge of Static Electricity
Meningitis
Magnetic Resonance Imaging (MRI)
X-Rays and CT Scans
Airports, Traveling, and Metal Detectors
Disposable Zinc Air Batteries
Medic Alert Bracelets and Necklaces
Contraindicated Medical Procedures

Head Trauma

A blow to the head in the area of the cochlear implant may damage the implant and result in a failure of the internal device, resulting in the need for revision surgery in some cases. Young children who are developing their motor skills are at greater risk to receive an impact to the head from a hard object (chair or table).

Children, including those with cochlear implants, should take caution when participating in contact sports. Whenever possible, they should use a helmet and refrain from direct contact to the head. While participating in sports such as boxing is highly discouraged, children may choose to participate in basketball, soccer, hockey, football or baseball, knowing that they are at a greater risk of damaging the internal device.

Many parents inquire about roller coasters. While you may want to remove the external speech processor as not to damage or lose it, riding on roller coasters is permitted. Caution should be taken when riding roller coasters that are considered a “rough ride” and have close head-guards as they may cause repetitious head trauma against these guards near the implanted site.

Prior to participation in any of these activities, please discuss details with your surgeon.

Discharge of Static Electricity

Your child will be safe if he/she receives a static electric shock, on the arm for example; however, a discharge of static electricity directly to the external speech processor can cause damage. Specifically, the programs or maps stored in the speech processor can be erased/degraded.

There is an internal shock protection in the speech processor that protects the internal cochlear implant (receiver/stimulator & electrode array) from being damaged. However, if an initial shock to the processor erases its protective features, any subsequent shocks to the external speech processor could travel to the internal cochlear implant.

In rare cases, this discharge could potentially damage the internal cochlear implant requiring revision surgery to replace the internal device. To prevent accidental electrical shocks to the external speech processor, always ground yourself (i.e. touching your hands to your child’s leg or arm) before touching the speech processor.

Activities that generate static electricity:

Plastic slides
Trampolines
Playing w/ Balloons
Plastic Ball Pits

It is recommended that the external speech processor be removed when engaging in the above activities.

Solutions to reduce the occurrence of static electricity:

Carpet: spray a mixture of half water/half fabric softener on your carpet throughout dry months
Dry air: use a humidifier or vaporizer to increase the air’s humidity
Sweaters / sheets: use fabric softener when doing laundry
Computer screen: anti-static shield
In general, touch something else before touching the speech processor in order to ground yourself, getting rid of the possible charge on that object.

SPECIAL WARNING about Van de Graaff generators: (there is one located in the St Louis Magic House)

Do not let your implanted child touch these machines as they can generate up to 200,000 volts of electricity, and can cause damage to the internal cochlear implant device, even with the external speech processor removed.

Meningitis

Meningitis is a viral or bacterial infection of the meninges (protective membrane around the brain) and cerebral spinal fluid. While some forms of meningitis are mild and resolve on their own, meningitis is a potentially serious condition owing to the proximity of the inflammation to the brain and spinal cord. The potential for serious neurologic damage or even death necessitates prompt medical attention and evaluation. Infectious meningitis, the most common form, is typically treated with antibiotics and close observation.

Children with hearing loss are at a higher risk than the general pediatric population for contracting meningitis. Children with cochlear implants are at an even greater risk. Vaccinations to protect against pneumococcal meningitis are available and strongly recommended before and after cochlear implantation.

Before the age of two years, your child should receive the four-part Prevnar 7-valent vaccination. Children over the age of two years should then receive Pneumovax 23-valent vaccination (this protects against more types of meningitis). Experts also recommended a second Pneumovax 23-valent vaccination five years after the first one. These vaccinations should be available at your pediatrician or local county health department.

Magnetic Resonance Imaging (MRI)

MRI is a tool to visualize internal parts of the body. It uses radio waves created by a powerful magnet. Individuals that have some types of metal in or on their body are not allowed to have MRIs. An MRI’s magnetic field can potentially pull and/or demagnetize the magnet and pull on the internal cochlear implant’s metallic components.

Individuals with cochlear implants are able to obtain MRIs; however, precautions need to be taken. The following are specifications for MRIs with each of the three cochlear implant companies. Please consult with your surgeon with regards to your child’s particular cochlear implant.

X-Rays and CT Scans

X-rays and CT scans are safe for your child and the internal cochlear implant; however, they can damage the external speech processor’s microphone or erase/degrade the programs stored in the processor. You simply need to remove the speech processor when undergoing medical X-rays (i.e. dentist). Airport X-rays are also a concern for the speech processor, but not your child or the internal device. (See the section on travel for more information about airports and X-rays.)

Airports, Traveling, and Metal Detectors

Air travel can expose the cochlear implant to damage from X-rays or static electricity. Do not pack the main speech processor or back-up processor in your checked luggage or your carry-on luggage, as these will be X-rayed. In addition, the conveyor belt at security is a risk for static electricity.

To be safe, place your equipment in the provided bowls and hand them to the security attendant to personally inspect and pass through security without placing them on the conveyor belt. X-rays and discharge of static electricity can potentially damage your speech processor’s microphone or erase/degrade the programs in the speech processor’s memory.

Rarely an internal cochlear implant device or the external speech processor will set off the metal detector at airport security. Just in case, always carry the ID card identifying your child as a cochlear implant recipient. If your child is required to remove the speech processor for inspection, notify the security officer that your child is deaf when the processor is off the head, and any instructions the officer may have for the child will need to be reviewed before removal of the speech processor.

If your child leaves the external speech processor on his or her head while walking through metal detectors, it will not damage the internal or external device, but the cochlear implant user may hear odd noises such as static or popping sounds. This will not physically harm the user, but many children are scared by these sounds. Therefore, we recommend taking the external speech processor off, or wearing it turned off when passing through metal detectors.

When you travel it is always a good idea to take the back-up speech processor and extra cables or other equipment as well as the contact information for your cochlear implant center. You should also keep a copy of the most current map/program settings with you so a local audiologist at your destination can re-load them if necessary. To find a local audiologist log onto your specific cochlear implant manufacturer’s website (Advanced Bionics, Cochlear Corp., or Med-El).

Disposable Zinc Air Batteries

The disposable batteries are a choking hazard as well as being potentially toxic to your child or pet if swallowed. If a battery falls on the ground, immediately find it and dispose of it properly. Please keep extra batteries in a tamper proof case. If you suspect that your child has ingested the batteries, please call your regional poison control center. Refer to the contact information below.

Missouri Regional Poison Center
Emergency Phone: (800) 222-1222; (314) 612-5705 (TDD/TYY)

Illinois Poison Center
Emergency Phone: (800) 222-1222; (312) 906-6185 (TTY/TDD)

Medic Alert Bracelets and Necklaces

During a medical emergency, medical professionals need to know your child has hearing loss and has a cochlear implant. This information will allow them to understand how to communicate and also be aware that certain tests and procedures should not be performed.

Your child should have some form of identification (ex. MedicAlert bracelet) to notify the medical personnel of the cochlear implant. This is especially important in the event that the speech processor has fallen off or broken, no family members or friends are present, or when the child cannot speak for himself or herself (i.e. unconscious from a trauma). To learn more or to order a MedicAlert bracelet or necklace, please see the brochure in the front of your binder.