1 cause of fatalities with big trucks?
(Ans- driver fatigue
DOT organization
(Ans- all subcategories are separate entities and require different
... [Show More] things
What is covered in NRCME training?
(Ans- federal motor carrier safety administration (FMCSA)
How long does NRCME certification last?
(Ans- 10 years with a 5 year update class
once a driver is certified, what is the longest it lasts?
(Ans- 2 years
SPE
(Ans- skill performance evaluation
Three copies of driver's certificate: who gets them and who has original for how long?
(Ans- driver, employer get copies
examiner keeps original for 3 years
Non discretionary standards
(Ans- immediately DQ the driver, examiner MUST follow standards
discretionary guides/recommendations
(Ans- limits steered by recommendations and examiners judgement
list the non discretionary DQers
(Ans- Hx of epilepsy, failed hearing exam, failed Vx exam, active insulin dependent DM
who oversees medical certification process?
(Ans- office of medical programs
how many X more is mortality rate for passenger vehicle vs large truck, in a crash between the two?
(Ans- passenger vehicle 5X more likely to die
where are physical standards for drivers listed?
(Ans- 49 CFR 391.41
define CMV
(Ans- commercial motor vehicle: any self propelled or towed MV used on a highway in interstate commerce to transport passengers or property...10k lbs or more, 8+ passengers for $$, 15+ passengers not for $$, hazardous materials
where is CMV defined?
(Ans- 40 CFR 390.5
where are medical examiner qualifications found?
(Ans- 49 CFR 391.43
Where are general qualifications for CMV drivers found?
(Ans- 49 CFR 391.11
list non-discretionary standards
(Ans- loss of limb, limb impairment, CV condition, respiratory dysfunction, HTN, RA/OA/orthopedic/muscular, mental disorder, drug use, alcoholism
"average" driver demographics
(Ans- male, 40+, sedentary, obese, smoker, poor eating habits
"average" driver medical health
(Ans- less healthy than average citizen, 2+ medical conditions, CV disease
list 9 occupational stressors for CMV drivers
(Ans- type of route, schedule, finances, vehicle, road conditions, environmental, type of cargo
when can a driver on insulin be certified?
(Ans- if he/she has FMCSA waiver - 49 CFR 391.64 OR federal exemption program
FMCSA definition of "severe hypoglycemia"
(Ans- seizure, LOC, need assistance from others, impaired cog fxn
if severe hypoglycemia, ask if driver has had reactions how frequently? (Ans- 1+ in last 12 months
2+ in last 5 years
what happens if driver has loss of proprioception? what about peripheral neuropathy?
(Ans- DQ and DQ
what if DM patient has resting tachycardia or orthostatic HOTN?
(Ans- DQ
what if driver has silver wire, cotton patches?
(Ans- qualify but recommend ophthalmologist yearly
what if driver has unstable retinopathy where neovascularization extends into vitreous?
(Ans- DQ
driver uses telescopic lenses?
(Ans- DQ
what if driver on incretin mimetics? what about other oral hypoglycemics? (Ans- certify for one year
DM exemption requires a driver to:
(Ans- annual endocrinology visit, annual optho visit, DM education, glucose monitoring
forced whisper test
(Ans- hear a forced whisper at no less than 5ft
audiometric testing limits
(Ans- average hearing loss no greater than 40 decibels
can driver wear hearing aids during forced whisper test?
(Ans- yes
audiometer should be calibrated to what standard?
(Ans- American National Standards Institute (ANSI) Z24.5-1951
driver wears a hearing aid. can you do in office whisper test? what about audiometry test?
(Ans- yes for whisper, no for audiometry
how to calculate hearing loss?
(Ans- determine what decibels heard at 500Hz, 1000Hz, 2000Hz in one ear. Add the results and divide by three. Result = average hearing loss.
Audiometric testing - results?
(Ans- qualify driver if less than 40dB hearing loss in good ear. both ears more than 40=DQ
how to convert from International Organization for Standardization to ANSI?
(Ans- minus 14 from 500
minus 10 from 1000
minus 8.5 from 2000
which test to do first, whisper or audiometric?
(Ans- doesn't matter as long as one is passed, driver is qualified
which otic diseases disqualify driver?
(Ans- BPPV w/ Sx in last 2 months
menieres
labyrinthine fistula
nonfunctioning labyrinths
Required vision tests?
(Ans- visual acuity (snellen/titmus), peripheral horizontal visual fields, color vision
Snellen visual acuity - ft away from chart and standards?
(Ans- 20 ft from chart, both eyes together and each eye must be 20/40
peripheral field of vision test?
(Ans- 70 degrees
what colors does driver need to distinguish between?
(Ans- green amber red
driver has retinopathy - what to do?
(Ans- you can certify but driver must have annual medical exam, annual optho exam
driver has unstable proliferative retinopathy
(Ans- DQ
driver can only meet requirements for Vx in one eye
(Ans- DQ
driver has contacts - one corrects for distance, one corrects for near acuity (Ans- DQ
Federal vision exempt program
(Ans- 2 years
monocular vision study
(Ans- 49 CFR 391.64, grandfathered in, driver can be certified for 1 year
you note HTN for first time in driver. what to do?
(Ans- certify for one year, after one year, certify for 3 months
driver had stage 1 HTN, certified for 1 yr + 3 months, now what?
(Ans- DQ
BP = 180/110
(Ans- DQ, if driver gets BP down, can certify for 6 months at a time pending 3 month interval checkups
first time stage 2 HTN, what to do?
(Ans- certify for 3 months...after this DQ if not lowered BP
driver had stage 2 HTN, got a 3 month certification and got BP down. now what?
(Ans- certify for 1 year after the INITIAL check (3 months ago)
name three neurologic standards, and choose the one that is nondiscretionary
(Ans- rheumatic/arthritic/ortho/muscular, epilepsy, mental...epilepsy is nondiscretionary
driver is on anticoagulant therapy for cerebrovascular disorder
(Ans- DQ
driver has cerebrovascular disorder - when to qualify?
(Ans- normalized INR, recert q1yr, monthly INR monitoring
TIA recurrence risk
(Ans- greatest in first few weeks following stroke, by one year post TIA, risk is 5%
driver had TIA
(Ans- wait 1 year then recert if not on anticoagulants
driver had stroke affecting cerebellum or brainstem
(Ans- 1 year wait, then recertify if not on anticoagulants and able to obtain clearance from neurologist
driver had stroke affecting cortical or subcortical region
(Ans- 5 year wait period then recertify if not on anticoagulants and you're able to obtain clearance from neurologist
intracerebral/subarachnoid bleed
(Ans- wait 1 year if in brainstem/cerebellum, wait 5 years if cortical/subcortical [Show Less]