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2.10 Preventive Sci Medicine And The Annual Physical
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Guest allanopie
2.10 PREVENTIVE SCI MEDICINE AND THE ANNUAL PHYSICAL
A most important function of SCI care is the prevention of complications of SCI. Yearly physicals are the cornerstone of the preventive medical mission.
a. Yearly physical exams should be performed at SCI centers or appropriately equipped SCI outpatient support clinics.
b. For the purpose of health maintenance and detection/prevention of SCI-related complications, the examination shall consist of no less than:
(1) Medical history - physical exam to include:
(a) Sensory and motor level reflex functions,
(B) Skeletal changes,
© ADL function changes (use of Functional Independence Measure (FIM) recommended),
(d) Skin integrity,
(e) Cardiovascular assessment (cardiac risk evaluation),
(f) Pulmonary function,
(g) Digital rectal examination, and
(h) Stool for occult blood.
(2) Dental evaluation;
(3) Psychosocial assessment (including vocational rehabilitation potential/readiness and sexuality);
(4) Rehabilitation-functional evaluation (changes due to aging included);
(5) Chest x-ray as indicated;
(6) Tonometry (when over age 35);
(7) Electrocardiogram (EKG), when indicated;
(8) Complete Blood Count (CBC) chemical profile (including lipids) - UA C/S, to include acid phosphatase/prostatic specific antigen (for patients over age 40);
(9) Urinary tract evaluation (function and morphology):
(a) Creatinine clearance;
(B) Urinary cytology;
© Renal sonogram;
(d) Computerized renal scan;
(e) Intravenous Pyelogram (IVP), when indicated;
(f) Cystoscopy with biopsy, when indicated, especially in patients with indwelling catheters; and
(g) Urodynamics evaluation every 3 years, or more frequently if indicated.
(10) Abdominal sonogram (gall bladder and aorta);
(11) Rectosigmoidoscopy (over age 40)/colonoscopy when indicated;
(12) Health promotion such as:
(a) Immunization (pneumovax (once), influenza);
(B) Anti-smoking information;
© Substance abuse screening and counseling; and
(d) Purified Protein Derivative (PPD).
(13) Dietary and nutritional assessment;
(14) Female SCI veterans, to include a:
(a) Pelvic exam,
(B) Pap smear,
© Breast exam, and
(d) Mammogram.
c. Letters to patients containing a summarization of their yearly physical results and the necessary follow-up care are certainly a most welcome and beneficial undertaking that will help the patients along for the coming year.
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