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July 2016 edition

DAME Newsletter - July 2016

From Principal Medical Officer, Dr Michael Drane

I'm delighted to announce that Dr Sanjiv Sharma has joined CASA as an additional Senior Medical Officer. Dr Sharma brings excellent aviation medical skills to the role and will work alongside Dr Peter Clem and Dr Mike Seah.

Dr Clem has just had a paper on Parkinson's disease published in the June 2016 edition of Aerospace Medicine and Human Performance Journal. These projects are of great value in increasing our understanding as well as informing aeromedical assessments. Other developments include a new look at cardiovascular risk assessment, in particular the role of calcium scoring and CT angiography. We are also awaiting the results of a review of the risks post-stroke, which should be available at the end of this year.

CASA recently provided further face-to-face MRS training which was well received. Answers to some of the most common questions raised in these sessions are included below. Training opportunities continue, and it is good to have a steady flow of new DAMEs to support aviation locally and internationally. Have you thought about doing the Diploma/Masters in Aviation Medicine?

Finally, I am delighted to be able to take some annual leave and will be away for most of August 2016. Please contact AvMed by phone or email if we can help.

With best wishes

Common MRS questions and answers

Why do DAMEs need to complete problem mapping?

Problem mapping is a core medical task, not a clerical one. Its purpose is to identify the main medical issues for the applicant by building a problem list. This informs the current and future assessments. It's essential that this information is medically relevant and accurate.

How can I make problem mapping quicker and easier?

In many cases, multiple findings can be mapped to a single problem, saving considerable time. If an applicant has had a heart attack for example, they might have findings for a hospital visit, elevated blood pressure, prescribed medication and another for the attack itself. You can map all of those findings to just the heart attack diagnosis.

  • Search for and select a relevant SNOMED finding.
  • Click the 'toggle' icon directly under the Problems List heading.
  • A blue dotted line appears around the 'Unallocated Findings' list.  Now you can click multiple findings and they will move over to the 'Findings' field in the 'Problem List' box.
  • A date must be included for each problem (SNOMED description). Click on a finding and a comment box will display with information about the finding.  If the information includes the date of the test or finding, enter this date into the 'Date Identified' field.  If the date is unknown, enter the examination date.

How do I map the age-related tests?

Age-related tests such as ECGs or routine blood tests, will appear in the 'Unallocated Findings' list. If these tests are within acceptable limits, there will be no diagnosis and you can map any/all of these findings to, 'Screening-no abnormalities detected (finding)'.  Search for 'NAD' in SNOMED.

Why do values have to be entered for each eye and for binocular vision in the Visual Acuity Table?

Unlike the previous medical records system, the new MRS allows gathering of any information about changes to visual acuity or eye health. Even when the standard for binocular acuity is being met, recording values for each eye can provide early clinical information for the examiner. This may allow pre-emptive treatment, for example in keratoconus.

Why are applicants submitting information about medical issues they had many years ago?

Applicants are required to enter their full medical history in MRS to the best of their knowledge. DAMEs can then consider an applicant's complete medical history during their examination, something that the old medical records system didn't allow. Significant medical matters have come to light as a result.

  • Tests, investigations or procedures completed in the past which were normal and have no bearing on current aviation safety can be mapped to, 'Screening-no abnormalities detected (finding)'.
  • Any questions that remain as 'Yes' will result in a finding to be mapped.  This finding will be visible again next year, but the problem mapping completed this year will remain – it will not have to be done again.
  • If the problem reoccurs or becomes relevant again, a new comment can be added and only then will the finding need to be mapped again.

Survey – Learning more about MRS

Improvements will continue to be made to MRS and we want to make sure you're confident with using new and existing functions.

In the next week, we will be sending you a request to complete a short survey about how we can best meet your training needs. Please take a moment to complete the five, simple questions. We will publish the results in the next DAME Newsletter.