I had a patient that I had been seeing for a while ask me where the best place is to get a Department of Transportation (DOT) physical exam is. I told him that I administer these exams! He was as happy a lark. However, once we administered the exams he seemed frustrated about the amount of exams that we went through. This blog is meant to help people understand what my clinic does to help with these exams, and why they are so important.
I usually let people know that when they come in for a DOT physical that they should come with a full bladder. There is a required urine test that measures for traces amounts of; protein, blood, glucose, and specific gravity. There are a number of problems that this test will screen for including; diabetes, kidney failure, liver disease, urinary tract diseases, and more.
An eye exam is also required for the DOT physical. Both eyes are checked for acuity, field of vision, and for color-blindness. Hearing is also checked. The minimum requirement for passing this test is the ability to hear a forced whisper from a distance greater than 5 feet. If this cannot be met, then a audiometer is used.
Not only is blood pressure checked at this point, but pulse is judged by beats per minute and by the health of the beat. The patient must be able to keep their blood pressure below 140/90 using medications or not. A blood pressure higher would only qualify for a temporary certificate.
A thorough physical exam is also performed. This means that the physical appearance of the eyes, ears, nose, throat, chest and stomach will be assessed. Further investigation of the eyes will be viewed through an ophthalmoscope that can see if there is retinal damage or signs of glaucoma. The ears will also be investigated thoroughly through an otoscope to assess the ear drum integrity. The heart will be auscultated to check of murmurs and other valve problems. The lungs will also be auscultated for problems with pneumothorax or build-up of phlegm. The abdomen will also be listened to for proper bowel sounds, and after that it will be palpated to check for organ enlargements and for tenderness. Hernias will also be checked for.
The spine and extremities will then be assessed for pain and integrity. This is probably my favorite part as this is something I am especially good at monitoring. The last thing to be checked is the check for neurological problems. This means balance and coordinate will be checked through the cerebellar and vestibular pathways. Sometimes this can be a screen for a problem that can come up in the future, but will not change the outcome of the exam unless it is extremely problematic.
The most important thing to think about is the fact that this exam is not done to help the person who is getting the exam. This exam is to make sure that the person getting the exam is safe to be out on the road. This ensures the safety of everyone else that is on the road. However, the safety of my patients is at a premium, and if they ever have a question I am more than happy to help.
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