OccMed Clinical Tools

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Quick Reference

PEPline (NCCC) 24/7

1-888-448-4911

Do not withhold first dose pending callback

Preferred PEP Regimen

Biktarvy (BIC/TAF/FTC)

1 tablet PO QD x 28 days

PEP Windows

⚡ Ideal: ≤2 hours
⚠ Hard cutoff: 72 hours
✓ Source HIV−: discontinue PEP

KDHE Reporting

HIV: 1 week from diagnosis
Acute HBV/HCV: 24 hours
Hotline: 877-427-7317

Exposure Time Calculator

Exposure date & time

Enter exposure date and time

HBIG Dose Calculator

Patient weight

Enter patient weight

0.06 mL/kg IM. Administer within 7 days of exposure.

Written Medical Opinion

29 CFR 1910.1030(f)(5) — due to employer within 15 days.

Quick Reference

KDHE BLL Reporting — 24hr

877-427-7317

ALL results — elevated and non-elevated. No threshold.

BLL Tiers

<5: Below NIOSH ref
5–19: NIOSH elevated
20–39: ACOEM action
40–59: Employer notify (5d)
≥60 GI / ≥50 Const ×2: MRP

OSHA MRP [VERIFY — NPRM active]

GI: ≥60 µg/dL ×2 consecutive
Construction: ≥50 µg/dL ×2
RTW: 2 consecutive <40 µg/dL

Poison Control

1-800-222-1222

Chelation / acute toxicity — 24hr

Lead Encounter

Sequential five-block encounter pathway — surveillance and acute visits.

TB Encounter

Post-exposure evaluation, baseline screening, and LTBI identification.

TST Interpreter

Induration (mm)

Risk category

BCG vaccinated?

Enter induration and risk category

Exposure Windows

Date of last exposure

Enter exposure date

KDHE Reporting

Active TB — Report within 4 hrs

877-427-7317

Active TB reported to KDHE

LTBI — Both required within 24 hrs

County health department KDHE (877-427-7317)

Reference

Post-Exposure Windows

Baseline IGRA: at first visit
Post-exposure test: 8–10 weeks
Skip baseline if >4 wks since exposure

Scope

Confirm LTBI → refer. TB treatment out of scope.

BP Decision

Reading 1

Systolic /

Reading 2

Systolic /

Prior Cert History

Enter two readings

OSA Routing

Immediate DQ Check

MVA associated with falling asleep Excessive daytime sleepiness while driving Epworth Sleepiness Scale ≥16 Diagnosed OSA — non-compliant with PAP Post-surgical OSA eval pending

BMI

kg/m²

STOP-Bang

Snoring loudly Tired / sleepy during the day Observed to stop breathing Pressure — treated or untreated HTN BMI >35 Age >50 Neck circumference >40 cm Gender — male

PAP Status (if diagnosed)

Complete screening above

Cert Period & Expiration

Exam Date

Active Conditions / Ceilings

ITDM (§391.46) — 12-month ceiling §391.44 Alternative Vision — 12-month ceiling BP Stage 1 — 12-month ceiling BP Stage 2 initial — 3-month (one-time) OSA initial cert — 12-month ceiling Stable cardiac condition — 12-month CKD Stage 4 — 6-month max MS / Parkinson's — 6-month max Renal transplant (<12 mo post-op) — 3-month Age ≥70 — practice default 12-month Seizure exemption — epilepsy — 12-month Seizure exemption — single unprovoked — 24-month

Select exam date to begin

Hard Disqualifiers

Cardiac — Absolute

ICD in place and active (no exemption program)

LVEF < 40% (any cardiac condition)

Sustained VT ≥30 sec or requiring intervention

Brugada syndrome

Long QT interval syndrome

Restrictive cardiomyopathy

Pacemaker for neurocardiogenic syncope

Rest angina or change in pattern <3 months

Neurological — Absolute

Narcolepsy (no cure; explicitly disqualifying)

Idiopathic hypersomnia

Meniere's disease

Labyrinthine fistula

Nonfunctioning labyrinth

TBI severe (penetrating dura or LOC >24 hrs)

CNS tumor — malignant or metastatic

Dementia

Psychiatric — Absolute

Active psychosis

Schizophrenia

First-generation (tricyclic) antidepressants

Medications — Absolute

Any Schedule I substance (incl. current marijuana use)

Kratom (opioid/stimulant; seizures reported)

Ropinirole (unpredictable sleep attacks)

Mirtazapine (significant impairment; typically avoid)

Vascular — Absolute

AAA symptomatic or recommended for repair

AAA growth >0.5 cm over 6 months

Thoracic aortic aneurysm >5.0 cm

PAD with pain at rest

Respiratory — Absolute

PaO₂ <65 mmHg (altitude <5,000 ft)

PaCO₂ >45 mmHg (any altitude)

Supplemental O₂ during driving (typically)

Conditional — Requires Criteria

HCM — disqualifying unless all 6 lower-risk criteria met

AAA 4–5.4 cm — disqualifying without vascular specialist clearance

ITDM — disqualifying if severe non-prolif. or prolif. retinopathy

Seizure disorder — disqualifying unless standard or exemption criteria met

Vision — disqualifying if <20/40 in better eye (corrected) or color blind

Active Monitor

Marijuana rescheduling — DEA hearing June 29 2026; DOT testing unchanged

Seizure NPRM §391.41(b)(8) — monitor federalregister.gov

Determination Pending

Exam Date

Information Needed

Cardiology clearance letter MCSA-5870 (ITDM — treating clinician) MCSA-5871 (Vision evaluation report) Sleep study results 90-day blood glucose records (ITDM) Specialist clearance letter Other (specify below)

Driver Has Valid Current MEC?

Select exam date to begin