Medical Examiner Completes
Blood Pressure/Pulse Rate — Medical Examiner Instructions
— You must measure:
Blood Pressure (BP)
- Only BP readings taken during the driver physical or follow-up examinations
may be used for certification decisions.
- BP greater than 139/89 must be confirmed with a second measurement
taken later during the examination.
- Record additional BP measurement in your comments on the Medical Examination
- Document pulse rhythm by marking the “Regular” or “Irregular”
- Record pulse rate.
- Record additional pulse characteristics in your comments on the Medical
Examination Report form.
NOTE: Trained assistive personnel may take and record the BP and
pulse. When BP, pulse rate, or both are significant factors in your decision not
to certify a driver, it is prudent for you to measure the readings yourself. However,
the Medical Examiner must sign the Medical Examination Report form. By signing the
Medical Examination Report form, you are taking responsibility for and attesting
to the validity of all documented test results.
Blood Pressure/Pulse Rate — Stages of Hypertension Guidelines Table
The instructions for medical examiners found in
49 CFR 391.43 Blood pressure (BP) stipulate that more frequent monitoring
is appropriate when a driver has hypertension at examination time or is being medicated
for hypertension. The Blood Pressure/Pulse Rate section of the Medical Examination
Report form has a table that summarizes the medical guidelines for BP measurements
and is equivalent to three stages of hypertension.
A one-time, three-month medical certificate is granted in two cases: where the driver
has a BP that is equivalent to Stage 2 hypertension, or a driver that was certified
with Stage 1 hypertension has not achieved a BP less than or equal to 140/90 at
recertification. This three-month certificate is a one-time issuance for the recertification
period and is not intended to mean once in the driver’s lifetime.
NOTE: These are recommendations. The medical examiner may use his/her
clinical expertise and results of the individual driver examination to determine
the length of time between recertification examinations.
The following table corresponds to the first two columns of the recommendation table
in the Medical Examination Report form. Column one has the blood pressure readings,
and column two has the category classification.