Post-Exposure Medical Exam
Because of potential health risks inherent in post-disaster work, a post-exposure medical exam should be administered to identify as early as possible the need for preventive measures or medical care.
- Type of work performed as response or recovery worker and circumstances under which that work was performed, with special attention to documentation of the geographic location of the work and when the work was performed. Protective measures (e.g., personal protective equipment) used
- Injuries sustained or symptoms experience during response work: description of injury and circumstances; treatment received; whether injury resolved or still present
- Signs and symptoms of potential illness: description of signs and symptoms, discuss new onset or exacerbation of preexisting condition, treatment, if any; symptom still present after return or new symptoms developed after return
- It may be appropriate to include specific screening for stress-related or emotional symptoms
Specific exposures and symptoms
Exposure to contaminated water:
- Concern if open sores, wounds, cuts, abrasion, or rashes were present before the exposure
- Concern if open sores, wounds, cuts, abrasion, rashes, swelling, or limitations with mobility are present post-exposure
- Concern if exposure involved contact with mucous membranes (eyes, nose, mouth)
Determine if any of the following symptoms is present:
- Eye infection
- Nausea, vomiting, stomach cramping and or diarrhea
- Fevers, upper respiratory illness
- Allergy symptoms – sneezing, nasal congestion, asthma exacerbation
- Weakness, fatigue, and loss of appetite
- Mental-psychologic issues (sleep patterns prior to, during and after response).
The Physical Exam Should Include:
- Vital Signs – including temperature
- Assessment of skin integrity
- Head/neck: conjunctiva, nose, mouth
- Lungs
- Heart
- Abdomen
- Extremities
- Mental state/depression evaluation
The Following Lab Tests Should be Performed:
- CBC with differential
- Serum chemistry – liver function tests, renal
- Hepatitis profile – A, B, C IgG/IgG
- Other labs that may be indicated based on the environment of operations and known public health threats in the region before, after, or as a result of the disaster