2010 BC Guide in Determining Fitness to Drive
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2010 BC Guide in Determining Fitness to Drive

2010 BC Guide in Determining Fitness to Drive 2010 BC Guide in Determining Fitness to Drive

pssg.gov.bc.ca
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13.07.2015 Views

ConditionType of drivingimpairment andassessmentapproachPrimaryfunctionalabilityaffectedAssessment toolsCoronary artery diseaseArrhythmiasValvular heart diseaseEpisodicimpairment:Medical assessment– likelihood ofimpairmentAll – suddenincapacitationDriver’s MedicalExamination ReportSpecialist’s reportCardiomyopathyCongestive heart failurePersistentImpairment:FunctionalassessmentCognitiveMay also resultin generaldebility or lackof staminaDriver’s MedicalExamination ReportICBC road testCognitive screening toolssuch as; MOCA, MMSE,SIMARD-MD, Trails Aor BDriveABLE assessmentEpisodicimpairment:Medical assessment– likelihood ofimpairmentAll – suddenincapacitationDriver’s MedicalExamination ReportSpecialist’s reportPost cardiac arrestPost-operative cognitivedecline (POCD)PersistentImpairment:FunctionalassessmentCognitiveDriver’s MedicalExamination ReportCognitive screening toolssuch as; MOCA, MMSE,SIMARD-MD, Trails Aor BDriveABLE assessment17.5 CompensationIndividuals with cardiovascular disease are not able to compensate for their functionalimpairment.164

GUIDELINES17.6 Policy rationaleThese guidelines are based primarily on recommendations contained in the final report of the2003 Canadian Cardiovascular Society (CCS) Consensus Conference Assessment of the CardiacPatient for Fitness to Drive and Fly. The CCS recommendations focus exclusively on thepotential episodic impairments associated with cardiovascular diseases.Additional guidelines have been added to address potential persistent cognitive impairmentcaused by congestive heart failure, and the potential for co-morbid cognitive impairment inrelation to cardiac arrest, and post-operative cognitive decline (POCD) following coronary arterybypass graft (CABG) surgery. Where guidelines have been added or changed, the rationale isincluded in the table.17.7 Private and commercial drivers with congenital heart defectsApplicationAssessment guidelinesFitness guidelinesOSMV determinationguidelinesConditionsRestrictionsRe-assessmentguidelinesPolicy rationaleThese guidelines apply to driver fitness determinations for privateand commercial drivers who have a congenital heart defect.If further information regarding an individual’s medical condition isrequired, OSMV will request: a Driver’s Medical Examination Report additional information from the treating physician, or an assessment from a cardiologist.Individuals may drive if they meet any guidelines related to a specificcardiovascular condition or event.Individuals are fit to drive.No conditions are required.No restrictions are required.If the defect has been repaired and the treating physician does notindicate any concerns, no re-assessment, other than routinecommercial or age-related re-assessment, is required. If the defecthas not been repaired, OSMV will re-assess every 5 years, unlessroutine commercial or age-related re-assessment applies.Congenital heart defects are not specifically addressed in the CCSguidelines. It is included here in recognition that a congenital heartdefect may be reported to OSMV. The nature of congenital heartdefects and their treatment is variable; therefore there are no specificfitness guidelines for them.165

ConditionType of driv<strong>in</strong>gimpairment andassessmentapproachPrimaryfunctionalabilityaffectedAssessment <strong>to</strong>olsCoronary artery diseaseArrhythmiasValvular heart diseaseEpisodicimpairment:Medical assessment– likelihood ofimpairmentAll – sudden<strong>in</strong>capacitation<strong>Drive</strong>r’s MedicalExam<strong>in</strong>ation ReportSpecialist’s reportCardiomyopathyCongestive heart failurePersistentImpairment:FunctionalassessmentCognitiveMay also result<strong>in</strong> generaldebility or lackof stam<strong>in</strong>a<strong>Drive</strong>r’s MedicalExam<strong>in</strong>ation ReportIC<strong>BC</strong> road testCognitive screen<strong>in</strong>g <strong>to</strong>olssuch as; MOCA, MMSE,SIMARD-MD, Trails Aor B<strong>Drive</strong>ABLE assessmentEpisodicimpairment:Medical assessment– likelihood ofimpairmentAll – sudden<strong>in</strong>capacitation<strong>Drive</strong>r’s MedicalExam<strong>in</strong>ation ReportSpecialist’s reportPost cardiac arrestPost-operative cognitivedecl<strong>in</strong>e (POCD)PersistentImpairment:FunctionalassessmentCognitive<strong>Drive</strong>r’s MedicalExam<strong>in</strong>ation ReportCognitive screen<strong>in</strong>g <strong>to</strong>olssuch as; MOCA, MMSE,SIMARD-MD, Trails Aor B<strong>Drive</strong>ABLE assessment17.5 CompensationIndividuals with cardiovascular disease are not able <strong>to</strong> compensate for their functionalimpairment.164

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