These regulations govern persons licensed as audiologists in the State. In this chapter, the following terms have the meanings indicated. Terms Defined. “Cerumen management” means the removal of cerumen which may affect the successful completion of audiological procedures. “Medical liaison” means a cooperative arrangement for consultation with a physician, preferably an otolaryngologist. “Universal precautions” has the meaning stated in COMAR 10.06.01.02B(10). Before the removal of cerumen, the licensee shall obtain the informed consent of the patient, or legally responsible adult, and maintain documentation. During cerumen removal, the licensee shall comply with the principles of universal precautions. The licensee shall be responsible for obtaining the training, knowledge, and skills necessary to perform cerumen management. Failure to obtain the training before performing cerumen management may subject the licensee to disciplinary action. The licensee shall obtain training that includes: Principles of cerumen management including the anatomy of the ear canal and the ear drum and classification of cerumen; Use of instruments; Techniques for cerumen removal; Recognition of complications; Recognition of contraindications including but not limited to: Only hearing ear; Perforated tympanic membrane; Inflammation, tenderness, or drainage from the ear canal or middle ear; Ear surgery within the past 6 months or tympanostomy tubes; Diabetes mellitus, HIV infection, bleeding disorder, or other medical contraindications; Actual or suspected foreign body; Stenosis or bony exostosis of the ear canal; Dizziness occurring during cerumen removal; Cerumen impaction that totally occludes the ear canal; and Clinical experience gained under the direct supervision of a qualified professional. The licensee shall maintain documentation evidencing the satisfactory completion of the required training. The licensee shall have established a medical liaison as defined in Regulation .02B of this chapter before performing cerumen removal. The licensee shall refer patients to or consult with as needed the medical liaison for patients requiring cerumen removal who exhibit contraindications. Health Occupations Article, §§2-101(n) and 2-205(a)(1), Annotated Code of Maryland Effective date: December 18, 1995 (22:25 Md. R. 1962) Regulation .05B amended effective January 6, 2005 (31:26 Md. R. 1863)