| |
significant or chronic disorders instead of one-time
events of minor illnesses or disorders.
An essential part of a complete physical
examination is the review of patient’s medical history.
The medical examiner is responsible for reviewing
items 9 through 24 of the SF 93. After reviewing these
items, the medical examiner uses item 25 to elaborate
on all “yes” responses (fig. 11-4).
Examiners
document conditions considered disqualifying as
“CD” and those considered not disqualifying as
“NCD.” Examiner’s signature and identification
information should be documented at the bottom of the
back side of the SF 93.
SPECIAL DUTY MEDICAL ABSTRACT,
NAVMED 6150/2
The NAVMED 6150/2, Special Duty Medical
Abstract, is a record of physical qualifications, special
training, and periodic examinations of members
designated to perform special duty, such as aviation,
submarine, and diving.
When members complete
special duty physical examinations and special
training, they should have entries made on their
NAVMED 6150/2. NAVMED 6150/2 entries require
the approval of a medical officer or designated
specialty medical service corps officer (i.e., aerospace
physiologist for aerospace physiology training).
If a special-duty-qualified service member is
found to be physically or mentally unfit, the service
member’s special duty status will be suspended either
temporarily or permanently. The reason(s) for the
member’s suspension and period of suspension are
recorded on the NAVMED 6150/2. Special pay
disbursements are often based on a member’s physical
and mental qualifications or continued requalification
for performance in a special duty.
PHYSICAL EXAM TESTING
PROCEDURES AND EQUIPMENT
LEARNING OBJECTIVE: Recall visual
acuity, color vision, audiometric, and EKG
test equipment and procedures.
Some of the basic procedures used to gather
information for a physical examination are taught in
Hospital Corpsman “A” School (e.g., vital signs,
venipuncture, and height and weight measurements).
However, other tests require advanced technical
expertise, such as serological testing, and pressure and
oxygen-tolerance testing. Some testing procedures
may be learned by on-the-job training (OJT) or by
short courses of instruction. These testing procedures
and the equipment used will be discussed in this
section.
VISUAL ACUITY
Visual acuity testing determines the ability of the
eye to discriminate fine detail. It is the most important
test of eye function. Throughout the Navy, there are
two accepted methods for testing visual acuity: the
Snellen chart and Jaeger cards, and the Armed Forces
Vision Tester. The Snellen chart and Jaeger cards are
used together to test visual acuity. The Snellen charts
test distant visual acuity; the Jaeger cards are used to
evaluate near visual acuity. The Armed Forces Vision
Tester checks both distant and near visual acuity, and
assists in evaluating other optical conditions.
The first step in testing for visual acuity is to find
out if the patient wears corrective eyewear. On the day
of their visual acuity testing, patients should bring in
their glasses. Contact lenses are not recommended for
use during visual acuity testing. Contact lenses cause
an increase in time needed for testing purposes, and
they tend to be an inconvenience for both the patient
and healthcare provider. Acuity testing is performed
with and without the glasses on, and the results are
documented in blocks 59 and 61 on the SF 88. Visual
acuity requirements are discussed in the MANMED.
Snellen Charts
Probably the most familiar of the visual testing
equipment, Snellen charts, are the preferred method
for testing distant visual acuity. Snellen charts can test
both monocular and binocular visual acuity.
Operational guidelines for Snellen charts are provided
by the chart’s manufacturer. Your local military
optometrist or eye clinic can also provide you
operational guidelines for Snellen charts. Specific
details and current conditions for testing with Snellen
charts are as follows:
· If the examinee wears corrective lenses, have
them remove the lenses before the examination.
Test the examinee first without corrective lenses,
and then with the corrective lenses in place.
· Hang the chart on the wall so the 20/20 line is 64
inches from the floor. Direct the examinees to
stand 20 feet from the chart.
Test each eye
11-10
|
