Occupational Medicine Practice Guidelines: Evaluation and Management of Common Health Problems and Functional Recovery in Workers

Overview

This guide provides information on generally accepted elements of quality care in occupational and environmental medicine. The audience for the book includes not only health care providers, but also insurance professionals, attorneys, and others involved in the administration of workers' compensation systems. This edition, like its predecessor, includes disability-duration data that reflect expert consensus opinion. New to this edition are disability-duration data that have been extracted from the National Health...
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Overview

This guide provides information on generally accepted elements of quality care in occupational and environmental medicine. The audience for the book includes not only health care providers, but also insurance professionals, attorneys, and others involved in the administration of workers' compensation systems. This edition, like its predecessor, includes disability-duration data that reflect expert consensus opinion. New to this edition are disability-duration data that have been extracted from the National Health Interview Survey. This edition also contains a rewritten and updated chapter on eye injuries, and a new appendix on evidence-based medicine. Annotation ©2004 Book News, Inc., Portland, OR
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Product Details

  • ISBN-13: 9781883595425
  • Publisher: O E M Health Information, Incorporated
  • Publication date: 12/1/2003
  • Edition description: Revised
  • Edition number: 2
  • Pages: 516

Table of Contents

Tables xiii
Algorithms xvii
Preface xx
I Foundations of Occupational Medicine Practice
1 Prevention 1
General Principles 1
Preventive Strategies and Tactics 5
References 16
2 General Approach to Initial Assessment and Documentation 21
Diagnostic Labeling 22
Medical History 23
Work History 28
Physical Examination 33
Communicating the Results of the Initial Assessment: Evaluating Fitness for Duty and/or Return to Work 34
References 37
Appendix 2A HIPAA Privacy Guidance 40
3 Initial Approaches to Treatment 43
Patient Information, Discussion, and Involvement 43
References 50
4 Work-Relatedness 55
Definitions of Causation and Related Term 56
Single, Multiple, or Competing Causation 57
Likelihood and Certainty 58
Types of Causation Analysis 59
Methods for Determining Work-Relatedness 60
Basics of Causation Analysis 61
Record Review 65
Literature Review 65
Epidemiologic Surveys 66
Summary 66
References 67
5 Cornerstones of Disability Prevention and Management 75
Consequences of Disability to the Individual 75
Consequences of Disability to the Employer 76
Functional Recovery and Return to Work 77
Early Steps to Reduce Time Away from Work 77
Managed Delayed Recovery 89
Referrals 92
Functional Restoration 92
References 92
6 Pain, Suffering, and the Restoration of Function 105
Pain Perception 106
Acute Versus Chronic Pain 107
Barriers to Optimizing the Management of Pain 108
Types of Patients and Specific Pain Syndromes 109
Principles of Pain Management 114
Preventing and Managing Chronic Pain 115
Enhancing Coping Skills 116
End Points and Outcomes 116
Summary 116
References 117
Appendix 6A Pain Assessment Models and Tools 125
7 Independent Medical Examinations and Consultations 127
Accepted Purposes of Independent Medical Examinations (IMEs) 127
Legal and Regulatory Requirements for Independent Medical Examinations (IMEs) 129
Qualifications of a Consultant or an Independent Medical Examiner 129
Examiner Skills and Abilities 131
Referral Issues and the Independent Medical Examination (IME) Process 132
References 139
Appendix Review of the Use and Attributes of Excellent Independent Medical Examinations 146
II Presenting Complaints
8 Neck and Upper Back Complaints 165
General Approach and Basic Principles 165
Initial Assessment 166
Medical History 168
Physical Examination 169
Diagnostic Criteria 172
Work-Relatedness 173
Initial Care 173
Activity Alteration 175
Work Activities 176
Follow-up Visits 177
Special Studies and Diagnostic and Treatment Considerations 177
Surgical Considerations 179
Summary of Recommendations and Evidence 181
References 189
9 Shoulder Complaints 195
General Approach and Basic Principles 195
Initial Assessment 196
Medical History 196
Physical Examination 200
Diagnostic Criteria 201
Work-Relatedness 201
Initial Care 201
Activity Modification 205
Work Activities 205
Follow-up Visits 207
Special Studies and Diagnostic and Treatment Considerations 207
Surgical Considerations 209
Summary of Recommendations and Evidence 212
References 220
10 Elbow Complaints 227
General Approach and Basic Principles 227
Initial Assessment 228
Medical History 228
Physical Examination 230
Diagnostic Criteria 232
Work-Relatedness 233
Initial Care 234
Physical Methods 235
Activity Alteration 236
Work Activities 236
Follow-up Visits 237
Special Studies and Diagnostic and Treatment Considerations 238
Surgical Considerations 238
Summary of Guideline Recommendations 241
References 248
11 Forearm, Wrist, and Hand Complaints 253
General Approach and Basic Principles 253
Initial Assessment 254
Medical History 254
Physical Examination 257
Diagnostic Criteria 258
Work-Relatedness 262
Initial Care 263
Physical Methods 265
Job Analysis 266
Work Activities 266
Follow-up Visits 268
Special Studies and Diagnostic and Treatment Considerations 270
Surgical Considerations 269
Summary of Recommendations and Evidence 271
References 279
12 Low Back Complaints 287
General Approach and Basic Principles 287
Initial Assessment 289
Medical History 291
Physical Examination 292
Diagnostic Criteria 296
Work-Relatedness 297
Initial Care 298
Physical Methods 298
Activity Alteration 301
Work Activities 302
Follow-up Visits 303
Special Studies and Diagnostic and Treatment Considerations 303
Surgical Considerations 305
Summary of Evidence and Recommendations 308
References 316
13 Knee Complaints 329
General Approach and Basic Principles 329
Initial Assessment 330
Medical History 332
Physical Examination 333
Diagnostic Criteria 335
Work-Relatedness 337
Initial Care 337
Activity Alteration 339
Work Activities 340
Follow-up Visits 341
Special Studies and Diagnostic and Treatment Considerations 341
Surgical Considerations 343
Summary of Recommendations and Evidence 346
References 353
14 Ankle and Foot Complaints 361
General Approach and Basic Principles 361
Initial Assessment 362
Medical History 362
Physical Examination 364
Diagnostic Criteria 367
Work-Relatedness 369
Initial Care 369
Physical Methods 369
Activity Alteration 371
Work Activities 372
Follow-up Visits 372
Special Studies and Diagnostic and Treatment Considerations 372
Surgical Considerations 374
Summary of Recommendations and Evidence 376
References 383
15 Stress-related Conditions 387
General Approach and Basic Principles 387
Models and Definitions 388
Initial Assessment 391
Medical History 392
Physical Examination 395
Diagnostic Testing 396
Treatment 398
Work-Relatedness 404
Follow-up Visits 405
Failure to Improve 405
References 405
16 Eye 415
General Approach and Basic Principles 415
Patient Management 416
Presenting Symptoms 417
Management of Red Eye 418
History 418
Observation of the Patient 419
Examination 419
Diagnostic Criteria 423
Special Studies and Diagnostic Treatment Considerations 426
Types of Red Eye 426
Red-Flag Conditions and Preferred Specific Treatment 437
Non-red-flag Conditions 442
Initial and Definitive Care of Red Flag and Non-red-flag Conditions 449
Management of Blurred Vision 456
Management of Visual Fatigue 458
Work-Relatedness 460
References 474
Additional Resources 482
Appendix Evidence-based Medicine: What does it mean? Why do we care? 491
Index 507
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