CDME Module 1: Overview-January 17, 2009

January 17, 2009

Pdf Summary

The U.S. Department of Transportation's Federal Motor Carrier Safety Administration (FMCSA) Medical Review Board (MRB) convened a public meeting on January 12, 2009, to discuss stroke and commercial motor vehicle (CMV) driver safety. The meeting included presentations on the findings of an evidence report on stroke and CMV driver safety and recommendations from the Stroke Medical Expert Panel (MEP). <br /><br />The evidence report found that individuals who have experienced a transient ischemic attack (TIA) or stroke have an increased risk of future stroke. The risk is highest immediately following a TIA and decreases over time but remains higher than individuals who have never had a TIA. The report also found that individuals who have had a stroke are at increased risk of a motor vehicle crash, although the absolute size of the risk is unclear.<br /><br />The MEP made several recommendations based on the evidence report. They recommended that individuals who have experienced a TIA be excluded from driving a CMV for at least one year, and individuals who have had a stroke be excluded from driving a CMV, with the potential for qualification after one year if they have remained free from recurrent stroke. The recommendations also included incorporating neuropsychological and on-road evaluations into the certification process for individuals who have had a TIA or stroke.<br /><br />During the meeting, the MRB discussed and approved several motions based on the recommendations from the MEP. They recommended changes to the current guidance on stroke and TIAs, including the requirement for examinations by neurologists and commercial driver medical examiners (CDMEs) for qualification to drive after a stroke or TIA. They also made recommendations on fitness for duty evaluations, future research on neurologic disease and stroke, and educational standards for CDMEs.<br /><br />Public comments included concerns about the exclusion of physician assistants (PAs) from providing CDME services under the recommendations. The MRB acknowledged the concerns and emphasized the importance of ensuring safety on the highways while valuing the contributions of PAs in healthcare.<br /><br />The meeting concluded with an update on current FMCSA activities, including the implementation of a National Registry of Certified Medical Examiners and the final rule on merging the medical certificate with the commercial driver's license.<br /><br />A detailed summary of the meeting will be posted on the MRB's website.

Keywords

U.S. Department of Transportation

Federal Motor Carrier Safety Administration

Medical Review Board

stroke

commercial motor vehicle driver safety

transient ischemic attack

motor vehicle crash

neuropsychological evaluation

on-road evaluation

physician assistants