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Give each member released from active duty a signed, legible copy of the SF 88, Report of Medical Examination. SPECIAL PHYSICAL EXAMINATIONS In addition to the occupational fields discussed previously, certain types of duty require a special physical examination before start of duty. These requirements are predicated on the basis of lack of adequate medical facilities, psychosocial con- sideration, extreme risk, or any combination of the above. For example, Antarctic Expedition (Operation DEEP FREEZE) personnel must have a preplacement physical examination to include psychiatric and psychological evaluations. Specific details are delineated in chapter 15 of the Manual of the Medical Department. Some other duties that require preplacement examinations are Fire Fighting Instructor Duty, State Department Duty, duty with a Correctional Custody Unit, and Recruit Company Commander. A determination of not physically qualified for special duty does not necessarily mean that the individual is not qualified for continued duty; he or she is probably still qualified for continued routine duty. OCCUPATIONAL HEALTH MEDICAL SURVEILLANCE EXAMINATIONS The Navy uses many materials in its workplaces, some of which are hazardous. To minimize the risk associated with these hazardous substances, the Navy developed the Navy Occupa- tional Safety and Health (NAVOSH) Program, part of which is the medical surveillance program. Medical surveillance examinations assess the health status of individuals as it related to their work. Although not truly physical examinations in the sense of this chapter, these surveillance ex- aminations produce specific information in regards to an individual’s health during actual or potential exposure to hazardous materials, i.e., the Asbestos Medical Surveillance Program (AMSP). Specific guidelines are provided in NAVMEDCOMINST 6260.3 and OPNAVINST 5100.23. Another example is the Occupational Noise Control and Hearing Conservation Pro- gram. Personnel who work in areas of high sound generation must be evaluated periodically for hearing loss. Specific guidance is provided in NAVMEDCOMINST 6260.5 and OPNAVINST 5100.23. TEST PROCEDURES AND EQUIPMENT Some of the equipment and procedures used to gather information for a physical examination should be common knowledge to all hospital corpsmen, i.e., vital signs, venipuncture, and height and weight. Others require the technical expertise of someone specifically trained, i.e., ad- vanced serological testing, or pressure and oxygen tolerance testing. You can learn most of the re- maining tests, procedures, and equipment easily through on-the-job training or short courses of instruction. Some of the intermediate level pro- cedures are described in this chapter. VISION Since to a great extent the perception of form and contour is the essence of all vision, an estima- tion of the acuity of the form sense is the most practical assessment of the sensitivity and effi- ciency of the eye. Therein lies the importance of the visual acuity, a measure of the smallest retinal image whose form can be appreciated. Throughout the Navy, there are two accepted methods for testing visual acuity: the Armed Forces Vision Tester, or the Snellen chart and Jaeger cards. The Snellen charts test distant visual acuity; the Jaeger cards, near visual acuity. The Armed Forces Vision Tester does both plus several other functions. Snellen Charts Probably the most familiar of the visual testing equipment, Snellen charts are the preferred method for testing distant visual acuity; it can test both monocular and binocular visual acuity. The Manual of the Medical Department, chapter 15, section VIII, provides specific details and condi- tions for testing with the Snellen charts, some of which follow: If the examinee wears corrective lenses, have him or her remove them before the examination. Test the examinee first without corrective lenses and then test with corrective lenses in place. Hang the chart on the wall so the 20/20 line is 64 inches from the floor. Direct the examinee to stand 20 feet from the chart. Test each eye in- dividually, then both eyes together. Do not allow the examinee to squint or tilt his or her head. With the gradation of the size of the letters ad- vocated by Snellen, the visual acuity is expressed 9-5


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