58lbs is normal grasp and prehension.

Transcription

1 DOT MEDICAL EXAMINER STUDY RESOURCE Courtesy of NRCME Public Records = Disqualify Driver (until conditions met for return.) The 4 Non-Discretionary Standards: Epilepsy Hearing Vision Insulin Dependent Diabetes Mellitus J = Untreated Sleep Apnea 58lbs is normal grasp and prehension. SPE = Skilled Performance Eval. Drivers get 2 years with a fixed :::::::::::::::::::::::.-' 1,... Urine Dipstick tests for: Blood Specific Gravity Sugar/glucose Protein , : = Narcolepsy : : Active Tuberculosis = Obstructive Sleep Apnea: 1 year qualification after 3 months with no symptoms post surgery or one month no symptoms from C-pap machine use. 2 Equipment to assist in breathing =. Hypoxemia at Rest = EDS- Excessive Daytime Sleepiness. RLS- Restless Leg Syndrome CZl Ul IS IT Incapacitating? Static- Progressive Episodic- Examiner Must Decide! Blood Gasses f'meas11re111e111 reveals a PaO2 of less than Hg at less than 5, Ji. Or /es.\ than 6mm Hg ahtll'e 5 Ji..-111(//or Carho11 dioxide greater 1' (at 1111y altitude) DISQUALIFY DR/I ER If Untreated = OSA- Obstructive Sleep Ap nea Severe cough Poor Meds Tolerance Frequent and Severe episodes FCV<65% PaO2 <65mm DISQUALIFY Alcohol Abuse is Disqualifying. If an examiner suspects alcohol abuse, the Designated Employer Represelllative should be informed alld the driver IMMEDIDIATELY Disqualified The DER is responsible for referral to a Substance Abuse Professio11al : Primary Alveolar Hypoventilation Syn. Idiopathic Hypersomnolence RLS with EDS Severe TBI = Moderate TBI = Do not on its own. Case by case basis, but must be seizure free for 2-5 years after injury. (See "Wait Times and Limits" Guide in Resource Library) Epilepsy: 2 or more unprovoked seizures.. To re-qualify must have I years no meds and no unprovoked seizures. Copyright 213 NRCME Training Systems, LLC

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3 Study Guide3 Un.Hable Angina: Pain at rest. Poor response to medications. Framingham 4-- is a Risk Scoring System for Heart. Based on correctable vs. non-correctable conditions. Myocardial Infarction 2 Month Wait Ejection Fraction> 4% Exercise Tolerance Test Normal. Tolerates Medications Passes CMV Physical Heart Failure Idiopathic Dilated Cardio- 1nyopathy... Most Common form of heart failure. Pacemaker: Non Sustained VT Definition > 4% and less than <5%. Exercise 1'1- erance Test,. ing is clone in: Ml Angioplasty Static Angina Pectoris CABG Return to Driving One month post implant. One year routine check. Coronary Bypass Grafting (CABG) also known as "Cabbage" 1. Return to Work 3 months post procedure. 2. Must be asymptomatic 3. Ejection Fraction of>4%. 4. Yearly Recertification 5. Tolerance of Medications 6. Must have a 5 year Exercise Tolerance Test due to likelihood of re-occlusion. Then, ETT yearly. Significant Pulmonary Hypertension Disqualify. Atrial Fibrillation Risk: Embolus- Stroke I year if rate control led via mcds. 3 Copyright 213 NRCME Training Systems, LLC

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8 Item Epilepsy Wait Period (no symptoms) 1 Years seizure free no anticon Certi y Period (needs new examif otherwise aualified) Headaches adeauate RX 2 years Single unprovoked seizure 5 yea rs, no meds, no seizure 1 year Acute/Chronic benign vestibulooathv CNS Infections Bad. Meningitis, viral encephalitis 2 mo, no sx No seizure: 1 year 2 Years 2 Years Bact. Meniaitis with earlv seizure 5 year 2 Years Viral Encohalitis with seizure 1 years 1 Year Neu romuscu la r /Periphera I Other/Exemption Period Epilepsy definition: 2 or more 1 Year unprovoked seizures with no time limit in between Nueropathv may have appeal after specialist eval Autonomic Neuropathy adequate RX 2 Year Diabetic Autonomic Neuropathy- 1 Year unless cardiac sx lntrcranial Hemm./subarrachnoid 1 year no seizure or risk of cerebellum/brainstem low seizure 1 year bid. seizure risk areas lntrcranial Hemm./subarrachnoid cortical/subcortical high seizure risk 5 year with risk of seizure 1 Year bid. areas Stroke 1 year no seizure risk 1 Year cerebellum/brainstem low seizure risk areas 5 year with risk of seizure 1 year cortical/subcortical high seizure risk areas TIA 1 year 1 Year no seizures no seizure meds Traumatic Brain Injury (severe) LOC for more than 24 hours and/or dural penetration. Traumatic Brain Injury (moderate) 2 year without seizure 1 Year 5 year with seizure 1 Year Traumatic Brain Injury (mild) 1 Year no seizure 2 Years 2 years with seizure 1 year Hernia adeauate RX 2 Years Benian Tumors 1 year 2 years Benign Supratentorial Tumors 2 years 2 Years Nephrooathv adequate RX 2 Years Dialvsis Oxvaen use lnolantable Cardio-defibrillator Electro convulsive therapy 6 mos symptom free after treatment 1 year Bipolar 6 mos symptom free: nonosvchotic 1 year Severe depression adequate RX 1 year Schizoohrenia Alcoholism Successfully complete RX 2 year Chantix for smokina cessation Peripheral Neuropathy Monocular vision Pick's Dss Non-fundionina labvrinth Anticoaaulants for CVA LOC > 3 min but < 24 hrs, no dural penetration LOC greater than 3 min but less than 24 hours.no dural oenetration Severe depressive, manic, suicidal: 1 year wait. Severe depressive mode with suicide: 1 year wait.

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10 NEURO WAIT TIMES NO SEIZURES AND OFF ANTI- CONVULSANTS 1 Year Mild TBI without seizure Stroke without seizure Hemmorage without seizure Transient lschemia Attack All tumors Bacterial Meningitis no seizure Viral Meningitis no seizure 2 years Mild TBI with early seizure Moderate TBI without seizure Supratentorial tumors 5 Years Moderate TBI with seizures Stroke with risk of seizure Hemmorage with risk of seizure One unprovoked seizure Bacterial Meningitis with early seizure 1 Years Epilepsy Viral Encephalitis

11 If diagnosis of restrictive impairment with an FVC less than 6% of the predicted value OR If diagnosis of obstructive airway disease with FEV 1 <65%. of predicted value and FEV/FVC ratio less than 65% I Obtain pulse oximetry.,. If Sp2 is <92 /o..- ObtainABG. If the Pa 2 on the ABG is less than 65 mmhg(altitude < 5, feet) or 6 mmhg (altitude above 5, feet) or PaC 2 greater than 45 mmhg (any altitude) Disqualify the driver.

12 7 Copyright 213 NRCME Training Systems, LLC

13 8 Copyright 213 NRCME Training Systems, LLC