Documentation and Correction of the RME

Question 1

NAVMED 6470/13 Blocks 3-10

Answer 1

Medical History (to be completed by the patient).
Any YES answers will require further evaluation, comments in block 14, and possible REAB submission.

Question 2

NAVMED 6470/13 Block 1

Answer 2

Type of exam (PE, RE, SE, TE).

Question 3

NAVMED 6470/13 Block 2

Answer 3

Examining Facility (name, address, and phone number).

Question 4

NAVMED 6470/13 Block 11

Answer 4

Dated CBC lab results (WBC and HCT) with facility lab range. Units are not required. The date format is DD MMM YYYY. Leading zeros are not required (i.e., January 9, 2015 can be written as 9 Jan 2015 vice 09 Jan 2015)

Question 5

NAVMED 6470/13 Block 12

Answer 5

Dated UA microscopy lab results in 12b. After 2 Dec 2022, block 12a is left blank even if dipstick results were obtained. The date format is DD MMM YYYY. Leading zeros are not required (i.e., January 9, 2015 can be written as 9 Jan 2015 vice 09 Jan 2015)

Question 6

NAVMED 6470/13 Block 13

Answer 6

Additional Studies. For radiobioassay tests performed in addition to the special studies required for the RME (e.g., internal monitoring).
Repeat CBC and UA test for abnormal results are not considered additional studies and should be documented in block 14.

Question 7

NAVMED 6470/13 Block 14

Answer 7

Summary of Abnormal Findings and Recommendations. This is where repeat labs are recorded, comments addressing abnormal findings are documented, and determinations of CD or NCD are made. Block 14 tells the story of what is happening. When there is insufficient space, the reverse side (additional notes) of the form can be used.

Question 8

NAVMED 6470/13 Block 15-19

Answer 8

Physical Exam. DRE is marked “NE” regardless of gender (no comment is required in block 14).

Question 9

NAVMED 6470/13 Block 20

Answer 9

Assessment. The examiner must mark PQ or NPQ. If NPQ is determined, a REAB submission is required. The REAB will respond with a letter, and that information is captured in block 20b along with the determination of PQ or NPQ.

Question 10

NAVMED 6470/13 Block 21

Answer 10

Patient signature and date.
The patient must review the medical history for accuracy, and have the results of the exam explained to them by the examiner or reviewing physician.

Question 11

NAVMED 6470/13 Block 22

Answer 11

Printed name or stamp of examiner, signature, and date.
Note: Compare the dates between blocks 21 and 22. Block 22 should besigned when the examiner finishes the physical exam. The patient should never date (block 21) before the examiner’s date in block 22.

Question 12

NAVMED 6470/13 Block 23

Answer 12

Printed name or stamp of reviewing physician, Signature, and date.
All reviewing authority signatures should indicate their training; UMO (Undersea Medical Officer), RAM (Aerospace Medicine Specialist), RHI (Radiation Health Indoctrination, the course for those trained at NUMI)

Question 13

NAVMED 6470/13 Block 24

Answer 13

Patient information (self-explanatory).

Question 14

Describe the approved methods for making administrative corrections on an RME

Answer 14

Administrative corrections for ionizing RMEs will be made by (1) drawing a single line through the erroneous entry, initialing and dating the change, then adding the correct entry. (2) Corrected entries may also be made in the Summary of Abnormal Findings block of NAVMED 6470/13.