If a driver got diagnosed with DVT and PE, Currently on Xeralto, NOT symptomatic. I just want to see if I am interpreting this right? He has to have a CT chest negative. Then repeat in 3 months and if negative then certify for a year? He has been on Xeralto for one month after diagnosis. Guidelines speaks of Coumadin only……
The commercial driver is at an increased risk for developing acute deep vein thrombosis (DVT) due to long hours of sitting as part of the profession. DVT can be the source of pulmonary emboli that can cause gradual or sudden incapacitation or death. Adequate treatment with anticoagulants decreases the risk of recurrent thrombosis by approximately 80%.
The driver should have a minimum waiting period of 3 months post PE and stable on anticoagulants for one month. If on coumadin, therapeutic INRs should be documented. There is no guidance on Xarelto or other newly available anticoagulants, so documentation from the treating physician familiar with the job of commercial driving should indicate the driver is stable.
There is no specific guideline or requirement for a CT of the chest, but certainly may be taken into consideration by the medical examiner, along with any other pertinent diagnostic and specialty examinations.
Of course, the driver should be otherwise physically able to perform heavy duties consistent with commercial driving. The maximum certification period after PE would be one year.
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