True or false: One component of a satisfactory ETT includes a heart rate >75% of predicted maximum
unless on beta blocker
False
1) Must attain a HR >85% of predicted maximum unless on beta blocker
2) No significant ST segment depression or elevation
3) Increased diastolic BP greater than 20 mmHg without angina
FMCSA mission statement
The FMCSA is focused on reducing crashes, injuries, and fatalities involving large trucks and buses
NRCME mission statement
The NRCME is focused on improving highway safety by producing trained, certified medical examiners
who can effectively determine if a CMV driver's health meets the FMCSA standards
What "title, part, section" is used to described the 13 standards that are used to determine driver
medical fitness for duty?
Title 49, Part 391, Section 41
49 CFR 391.41
What are the 3 disqualifies that do not depend on medical clinical interpretation?
1) Vision
2) Hearing
3) Epilepsy
True or false: Insulin dependent diabetes is a disqualifier that does not depend on medical clinical
interpretation
False - this used to be a disqualifier but is no longer the case as of 2018
Any self-propelled or towed motor vehicle used on a highway in interstate commerce to transport
passengers or property when the vehicle:
1) Has a combined gross of weight or weight rating of <10,001 lbs
2) Is designed or used to transport >8 vehicles (including the driver)
3) Is used to transport >15 passengers (including the driver)
4) Transport hazardous materials
Commercial Motor Vehicle
Trade, traffic, or transportation:
1) Between a place in a State and a place outside such State
2) Between two places in a State through another State or a place outside of the US
, 3) Between two places in a State as part of trade, traffic, or transportation originating or terminating
outside the State or US
Interstate Commerce
What act requires drug and alcohol testing of safety-sensitive transportation employees in
transportation industries?
The Omnibus Transportation Employee Testing Act of 1991
True or false: As the medical examiner, you are NOT diagnosing and treating person medical conditions
True! It is your duty to educate and refer the driver for further evaluation if you suspect an undiagnosed
or worsening medical problem, but you are not treating.
"As the medical examiner, you are not treating the provider and do not treat or diagnose in this
setting"
Stage I HTN
140-159/90-99
Stage II HTN
160-179/100-109
Stage III HTN
SBP ≥ 180
DBP ≥ 110
If a driver comes in with a BP of 144/92, what should you do?
A BP >130/89 must be confirmed with a 2nd measurement taken later during the examination
NOTE: When BP and pulse rate are significant factors in why you are not certifying a driver, if
is crucial for you to re-measure them!
If a driver has a confirmed BP of 158/98, what should your certifying decision be?
The driver may be certified for one year. At recertification, if the BP is not under <160/100, the driver
can be given a one-time certificate for 3 months. If BP is <140/90, the driver may be certified for
another year
If a driver has a confirmed BP of 181>111, what should your certifying decision be?
Disqualified
- The driver should not be certified until his/her BP is reduced to <140/90. Once this is achieved, the
driver can be certified for 6 months
If a driver has a confirmed BP of 178/108, what should your certifying decision be?