HomeMy WebLinkAboutMedical ProtocolCity of Miami, Florida
Police Physical Examination Services RFP 03-04-081
Attachment A
MEDICAL PROTOCOL
(Annual Physicals - Department of Police)
I. PHYSICAL EXAMINATION COMPONENTS
A. Medical History - Provider shall obtain a complete and
thorough medical history on the employee.
Provider must also perform a Health Risk Profile on the
employee. The purpose of this appraisal tool is to identify
a person's major health risks and how lifestyle habits
affect these risks. This confidential profile should
prioritize and explain the necessary life-style changes to
reduce risks.
Specifications: - The profile should have the following
characteristics:
1. Projects the relationship between chronological age
and risk age.
2. The profile will clearly and concisely show
participants both immediate and long-term effects of
their life-styles.
3. The profile used will be one that can derive a
management report identifying the relationship
between health risks and costs to the organization,
B. Physical Examination (By Board Certified Physician)
Physical Examination DONE BY INSPECTION, PALPATION,
PERCUSSION AND AUSCULTATION to include the following:
General appearance
Height
Weight
Head, Scalp, face
Neck (THYROID, LYMPHS, VESSELS)
Ears (INTERNAL AND EXTERNAL CANALS AND CERUMEN)
EAR DRUMS (PERFORATION)
Nose (SINUSES)
Throat (CONDITION OF TONSILS)
Mouth (TONGUE, TEETH, AND GUMS)
Spine (OTHER MUSCULOSKETAL)
Skin (SCARS, RASHES) LYMPHATICS
Upper extremities (STRENGTH, RANGE OF MOTION)
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City of Miami, Florida
Police Physical Examination Services RFP 03-04-081
Lower extremities (STRENGTH, RANGE OF MOTION)
Lungs, chest wall, breasts (PHYSICIAN WILL OFFER TO
PERFORM BREAST EXAMINATION), back
Vascular System (VARICOSITIES, ETC.)
Heart (thrust, size, rhythm, sounds)
Endocrine system
Vital signs, T,P,R, (B/P both arms)
Neurological evaluation
Mental Status, memory, orientation, judgment,
intellect, affect
Abdomen, Viscera (check for hernias) -EVALUATION BY
INSPECTION, PALPATION, PERCUSSION & AUSCULTATION)
External Genitalia - EVALUATION BY INSPECTION,
PALPATION, PERCUSSION & AUSCULTATION)
ANUS AND RECTUM - DIGITAL RECTAL EXAM (OPTIONAL) FOR
EXAMINATION OF PROSTATE IN MEN AND TO CHECK FOR THE
EXITENCE OF OCCULT BLOOD IN BOTH MEN AND WOMEN.
C. Laboratory Work -up
1. Hematology panel
Complete Blood Count (CBC) with differential
2. Biochemistry Profile 25 and Complete Lipid Profile
with ratios and TSH (Thyroid)
4. Urinalysis (Microscopic)
D. Opthalmological Evaluation
1. Visual Acuity - Both corrected and uncorrected
vision should be tested and recorded.
Note: A monthly report should be forwarded to
the Department of Employee Relations, listing
employees that do not meet the following vision
requirements: 20/50 each eye uncorrected; 20/30
each eye corrected. It should also be noted if the
individual wears glasses or contact lenses.
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City of Miami, Florida
Police Physical Examination Services RFP 03-04-081
2. Physical Examination by a Board certified
Physician to include:
a)
b)
c)
d)
e)
f)
Pupils
Extra -Ocular movement
Conjunctiva
Sclera
Fundoscopic examination
Color vision
E. Pulmonary Function Test
(Screening for obstructive and restrictive diseases)
Vital Capacity and FEV 1
Utilize a spirometer that measures function by
volume, not flow. Minimal reported information
should be FVC, FEV 1, FEV 1/FVC%, FEF25-75%, and
MVV. All volumes should be reported in absolute
values (liters), as well as percentage of age,
sex, and adjusted normals.
F. Electrocardiogram
Twelve lead resting EKG. Report with mounted rhythm
strip included in medical chart.
G. Audiological Screening
Test normal hearing range, 500 to 4000 HERTZ, with a
calibrated audiometer in a sound treated both or room.
Note: A monthly report should be forwarded to the
Department of Employee Relations listing employees with
hearing acuity loss of 40 decibels or greater for the
frequencies 500, 1000, 2000, 3000, and 4000 cycles.
H. PPD Skin Test -performed by Mantoux method (required).
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City of Miami, Florida
Police Physical Examination Services RFP 03-04-081
I. ADDITIONAL/OPTIONAL EXAMS
OPTIONAL
1. Radiological Screening (RECOMMENDED EVERY 3 YEARS)
Standard PA and Lateral Chest (posterior, anterior, and
lateral chest views).
2. Cardiovascular Stress Test
A cardiovascular stress test shall be administered to
designated sworn personnel with a positive history of
cardiovascular disease, in themselves or their family, and
to all those 40 years of age or older. When recommended by
the examining physician, the following additional tests may
be performed: Echocardiogram, Thallium Stress, Exercise Muga
Stress Test.
3. DIGITAL RECTAL (MALES AND FEMALES) INCLUDING A STOOL
HEMATEST FOR OCCULT BLOOD.
4. Pap Smear - RECOMMENDED once annually.
5. Mammogram
To be offered to female police officers age 40 and
older utilizing the following guidelines:
Age 40 - 49
Age 50 - and over
Family history of cancer
6. CA 125
- every 2 years
-- every year
- every year
To be offered only to those female police officers that
have previously been diagnosed with OVARIAN cancer OR A
STRONG FAMILY HISTORY.
7. PSA
OFFERED TO ALL MALES. RECOMMENDED FOR male police
officers age 40 and older; AND AFRICAN-AMERICAN MALES
35 AND OLDER.
8. Comprehensive Hearing Examination
Should be performed on all police officers with hearing
acuity loss off 40 decibels or greater for the
frequencies 500, 1000, 2000, 3000, and 4000 cycles.
9. 24 Hour Holter Monitor
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City of Miami, Florida
Police Physical Exanzinalion Services RFP 03-04-081
10. HBSAB Titer
11. FLEXIBLE SIGMOIDOSCOPY - FOR POLICE OFFICERS 50 YEARS
AND OVER, OR TO BE CONDUCTED UPON RECOMMENDATION OF THE
EXAMINING PHYSICIAN.
ADDITIONAL
1. Police Department DIVE TEAM
Basic physical, plus:
a) Bilirubin Direct and Total
b) Cholinesterase
c) Heavy Metal Screening Quantitative for Pb (Lead),
As (Arsenic), Hg (Mercury)
d) Tonometry
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City of Miami, Florida
Police Physical Examination Services RFP 03-04-081
HEPATITIS A AND B IMMUNIZATION PROTOCOL
Hepatitis A immunization protocol shall be conducted as follows:
The first visit shall include a training module. This
visit shall be scheduled between 7:00 a.m. to 5:00 p.m.
Monday through Friday, excluding legal holidays.
- After the training module, those individuals to be
immunized will be given the first dose of the Hepatitis A
vaccine (Havri4 A Adult) followed by the second
injection six (6) months after the first. Hepatitis A
does not require a blood titer after vaccination. These
vaccinations will be by intramuscular injection. The
dosing schedule for Hepatitis A vaccination is (0 and 6
months).
Hepatitis B immunization protocol shall be conducted as follows:
- The first visit shall include a training module and
(HBSAB) titer. This visit shall be scheduled between 7:00
a.m. to 5:00 p.m. Monday through Friday.
- After the training module, and the (HBSAB) titer if
applicable, those individuals to be immunized will be
given the synthetic vaccine (e.g. Recombivax HB or
Engerix HB). These vaccinations will be by intramuscular
injections.
The second visit will consist of the initial injection
followed by the second injection one (1) month after the
first, and the third injection, six (6) months after the
first. A (HBSAB) titer will be drawn 1-2 months after the
last injection.
- It is now recommended that those individuals who do not
develop positive HBSAB's after a primary series, repeat
the entire series.
Hepatitis A and B combination vaccine (Twinrix) - protocol shall
be conducted as follows:
The first visist shall include a training module. This
visit shall be scheduled between 7:00 a.m. to 5:00 p.m.,
Monday through Friday, excluding legal holidays.
After the training module, those individuals to be
immunized will be given the first dose of the synthetic
vaccine (Twinrix) followed by the second injection one (1)
month after the first, and the third injection six (6)
months after the first. These vaccinations will be by
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City of Miami, Florida
Police Physical Examination Services RFP 03-04-081
intramuscular injection. The dosing schedule for Hepatitis
A and B combination vaccinations is (0-1-and 6 months).
Covers the following employee classifications:
1) Police (all sworn)
2) I.D. Aide
3) Property Specialist 1 and II
4) Others as designated
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