The Med-Track Process for Doctors : Performing the Med-Track Physical
Summary
The Physical Examination
- The physical examination is a very important part of the medical assessment and can uncover numerous health problems.
- The examination must be thorough, and the person must be undressed.
- Blood Pressure (BP) is to be reported in millimeters of Mercury (mmHg). If the first BP is not normal, it should be checked a second time after a 5-minute rest lying down. If still abnormal, a third BP will be measured after 5 more minutes of rest lying down. Note: Hypertension is generally defined as blood pressure above 140/90 mmHg at age 20 years, rising to 170/110 mmHg at age 70 years.
- Height should be in centimeters (cm) and weight in kilograms (kg) to allow calculation of the Body Mass Index (BMI). Obesity relates to values in excess of 30 (formula for BMI = weight/height cm2).
Testing Vision and Hearing
- The patient's vision must be tested both with and without eyeglasses or contact lenses when relevant. Should his/her vision not be correct, the "With glasses" column should be ticked.
- The recommended vision test is Monoyer tables at 5 meters for acuity, and Ishihara tables for color perception.
- The recommended basic hearing test is the tuning fork 256 Hz. However, measurement of auditory acuity is best performed by screening audiometry. Where the measured loss is greater in the better ear than 35 decibels for lower frequencies or 60 decibels for higher frequencies, special assessment of the individual is advised.
Vaccinations (Schlumberger Vaccination Guide)
The following vaccinations are recommended for all international employees/dependants in Schlumberger:
- Tetanus
- Poliomyelitis
- Typhoid
- Hepatitis A
- Hepatitis B
Yellow fever is mandatory for persons who may work or live in Africa and/or South America.
Meningitis A & C vaccination should be administered to persons who may work or live in West Africa.
Diphtheria vaccination is recommended to persons who may work or live in C.I.S. countries and Eastern Europe.*
Childhood vaccinations should be updated if necessary (MMR, DTCP, etc.).
Other vaccinations may be necessary depending on the time of travel, local epidemics and destination.
Malaria Prevention
If the employee/dependent is supposed to live, work or travel in a zone of endemic malaria transmission, give him appropriate information regarding malaria prevention (insect bite prevention and adapted malaria chemoprophylaxis).
Please refer to the consensus statements of:
Drug Testing
Drug testing is mandatory for Med-Track pre-employment medical examinations only and only if permitted by local legislation.
Employee must provide written consent prior to testing.
Chain of custody of urine sample must be imposed.
The following drugs must be tested in the urine:
- Amphetamines
- Cannabinoids
- Cocaine
- Opiates
Please refer to Drug Testing Recommendations (OGP) 
.
NOTE: Drug test kits are produced by the USA company, Progressive Medical Technologies (Immunochrome Multitest® or TRIAGE® tests are also available) or similar.
EKG and X-rays
EKG
The 12 classical leads are required. Interpretation of the results shall always be made by a physician (computer interpretation alone is not acceptable). If the resting EKG is grossly abnormal a consultation with a cardiologist or a stress EKG may be justified.
X-rays
Chest X-ray: A classical front film is to be performed systematically where legally and medically acceptable. The profile will be completed only if clinically indicated.
Blood, Urine and Stool Testing
Blood Type
Test blood type and Rhesus only if not already known.
HIV Testing
Schlumberger does not request HIV testing. There should be no HIV testing unless specifically requested by the employee or when required for visa purposes.
Employee must give written consent prior to any HIV testing.
Urine and Stool Analyses
The parasitic examination will be performed on fresh stools (whenever possible) and completed if clinically indicated or if the person lives or comes from a tropical country.
Parasites and ova search shall focus on the following:
The parasitic examination will be performed on fresh stools (whenever possible) and completed if clinically indicated or if the person lives or comes from a tropical country.
Parasites and ova search shall focus on the following:
- Entamoeba histolytica/minuta/coli
- Ascaris lumbricoides
- Blastocystis hominis
- Escherichia coli
- Giardia lamblia
- Trichocephalus
- Schistosomiasis
- Filariosis
Occult blood can be checked with a dip-stick (hemoccult).
Urine test is performed with a dipstick that is read immediately after use. The following substances shall be tested:
- Albumin
- Sugar
- Blood
Reporting Lab Results
All units used are according to the International System (IS):
| Units | |
|---|---|
Red Blood Cell count (RBC) |
millions/mm3 |
Hemoglobin |
g/dL |
Hematocrit |
% |
White Blood Cell count (WBC) |
thousands / mm3 |
Differential, including segmented, |
% |
Erythrocyte Sedimentation Rate (ESR) – 1st hour only |
mm /hour |
SGOT (ALAT) |
UI/l |
SGPT (ASAT) |
UI/l |
Gamma GT |
UI/l |
Uric Acid |
µmol/l |
Creatinine |
µmol/l |
Glucose (Fasting only) |
mmol/L |
Total Cholesterol |
mmol/L |
Triglycerides |
mmol/L |
Med-Track Plus : Tests performed
Med-Track Plus is reserved only for high mobility employees/dependants who are over 40 years of age.
What tests are proposed in Med-Track Plus and what do they test for?
- Tonometry - must be done by an ophthalmologist - tests for glaucoma, a disease that can lead to blindness
- Additional blood tests:
- PSA (for men only) - tests for prostate cancer
- CEA - tests for cancer of the colon
- TSH - tests for abnormalities of the thyroid gland including cancer of the thyroid
- Alkaline phosphatase - an indicator of bone and/or liver problems
- Functional Respiratory Testing - detects any important reduction in functioning of lungs - predictive particularly for smokers
- Cardio-vascular risk factors:
- Stress Test - electrocardiogram on a tread mill or bicycle - tests the heart's endurance and can detect the clogging of a coronary artery.
- Carotid Echo-Doppler - detects any clogging of the arteries in the neck
- Cardiac Echography - assesses the correct functioning of the heart muscle and valves
- Abdominal and pelvic echography - detects any abnormality in the abdomen and pelvic areas
- For men only:
- Prostate echography - detects any abnormality, including cancer, in the prostate glan
- For women only:
- Mammogram - detects any abnormality in the breasts
- PAP smear - detects abnormalities in the uterine cervix
