COHN cheat sheet

Normal adult resting vital signs: heart rate 60-100 bpm, respiratory rate 12-20/min, oral temperature 36.5-37.5 C; blood pressure below 120/80 mm Hg, with stage 1 hypertension starting at 130-139 systolic or 80-89 diastolic.

Body mass index = weight (kg) / height (m) squared; classification is underweight <18.5, normal 18.5-24.9, overweight 25.0-29.9, obesity 30.0 or greater.

Spirometry interpretation: a post-bronchodilator FEV1/FVC ratio below 0.70 indicates persistent airflow obstruction consistent with COPD; a reduced FVC with preserved ratio suggests restriction.

OSHA standard threshold shift = average change of 10 dB or more at 2000, 3000, and 4000 Hz in either ear relative to the baseline audiogram; a shift of 25 dB or more at any single frequency is also reportable on the recordable hearing loss criteria.

Tuberculosis screening: a TST induration of 5 mm or more is positive for HIV-infected persons, close contacts, and those with abnormal chest films; 10 mm or more for most other adults; 15 mm or more only when no risk factors exist. IGRA is preferred for BCG-vaccinated workers.

Bloodborne pathogen exposure: HIV post-exposure prophylaxis should begin as soon as possible, ideally within hours and no later than 72 hours, for a 28-day course; unvaccinated workers exposed to HBV receive hepatitis B immune globulin plus the vaccine series.

Heat-related illness: heat exhaustion involves heavy sweating, weakness, and cool clammy skin; heat stroke is core temperature 40 C or higher with central nervous system dysfunction and requires immediate cooling and emergency transport.

Case management documentation must distinguish work-related from non-work-related conditions, record objective findings, and maintain confidentiality of protected health information separate from the general personnel file.

OSHA incidence rate = (number of recordable cases x 200,000) / total employee hours worked; the 200,000 constant represents 100 full-time workers at 40 hours per week for 50 weeks.

DART rate = (cases with days away, restricted work, or job transfer x 200,000) / total employee hours worked.

Recording timelines: entries on the OSHA 300 Log are made within 7 calendar days of learning of a recordable case; a fatality is reported to OSHA within 8 hours and an in-patient hospitalization, amputation, or loss of an eye within 24 hours.

Recordability criteria: death, days away from work, restricted work or transfer, medical treatment beyond first aid, loss of consciousness, or a significant injury diagnosed by a physician or other licensed health care professional.

FMLA eligibility: 12 workweeks of unpaid leave per 12-month period requires 12 months of service, 1,250 hours worked in the preceding 12 months, and employment at a site with 50 or more employees within 75 miles.

ADA compliance: medical examinations may be required only after a conditional offer of employment; all medical inquiries of current employees must be job-related and consistent with business necessity, and records are kept in separate confidential files.

FTE calculation: FTE = total paid hours / 2,080; budget variance = actual expense minus budgeted expense, expressed as a percentage of budget.

Program return on investment = (net program benefit / program cost) x 100, and cost-benefit analysis compares total monetary benefits to total program costs.

Hierarchy of controls, most to least effective: elimination, substitution, engineering controls, administrative controls, then personal protective equipment.

OSHA noise exposure: permissible exposure limit 90 dBA as an 8-hour time-weighted average with a 5 dB exchange rate; a hearing conservation program including audiometric testing is required at an 85 dBA action level.

Respirator program requirements: medical evaluation before fit testing or use, annual quantitative or qualitative fit tests for tight-fitting respirators, and user seal checks each time the respirator is donned.

Permit-required confined space entry requires atmospheric testing before entry: oxygen between 19.5 and 23.5 percent, combustible gas below 10 percent of the lower explosive limit, and contaminant levels below exposure limits.

Hazard Communication requires a Safety Data Sheet with 16 standardized sections for each hazardous chemical, plus container labels with signal words and pictograms, and training before exposure occurs.

Bloodborne Pathogens standard: a written exposure control plan reviewed and updated at least annually, hepatitis B vaccination offered within 10 working days of assignment, and PPE provided at no cost.

Workers' compensation is a no-fault system covering injuries arising out of and in the course of employment; the exclusive remedy doctrine generally bars tort claims by the employee against the employer.

NIOSH lifting equation produces a recommended weight limit; the lifting index equals the actual load divided by the recommended weight limit, and a value above 1.0 signals elevated risk of lifting-related injury.

Transtheoretical model stages: precontemplation, contemplation, preparation, action, maintenance, with relapse possible; interventions are matched to stage rather than applied uniformly.

The Five A's counseling sequence for tobacco and other behavior change: Ask, Advise, Assess, Assist, Arrange follow-up.

Evidence hierarchy from highest to lowest: systematic reviews and meta-analyses of randomized controlled trials, individual RCTs, cohort studies, case-control studies, case series, expert opinion.

Sensitivity = true positives / (true positives + false negatives); specificity = true negatives / (true negatives + false positives); positive predictive value depends on prevalence.

Health Belief Model constructs: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy.

PICO format for clinical questions: Population, Intervention, Comparison, Outcome; it converts a practice problem into a searchable, answerable question.

Program planning logic model sequence: inputs, activities, outputs, short-term outcomes, intermediate outcomes, long-term outcomes; evaluation design is selected before implementation.

Knowles' adult learning principles: adults are self-directed, problem-centered, internally motivated, and learn best when content is immediately applicable and builds on prior experience.

Normal adult resting vital signs: heart rate 60-100 bpm, respiratory rate 12-20/min, oral temperature 36.5-37.5 C; blood pressure below 120/80 mm Hg, with stage 1 hypertension starting at 130-139 systolic or 80-89 diastolic.

Body mass index = weight (kg) / height (m) squared; classification is underweight <18.5, normal 18.5-24.9, overweight 25.0-29.9, obesity 30.0 or greater.

Spirometry interpretation: a post-bronchodilator FEV1/FVC ratio below 0.70 indicates persistent airflow obstruction consistent with COPD; a reduced FVC with preserved ratio suggests restriction.

OSHA standard threshold shift = average change of 10 dB or more at 2000, 3000, and 4000 Hz in either ear relative to the baseline audiogram; a shift of 25 dB or more at any single frequency also meets criteria.

Tuberculosis screening: a TST induration of 5 mm or more is positive for HIV-infected persons, close contacts, and those with abnormal chest films; 10 mm or more for most other adults; 15 mm or more only when no risk factors exist. IGRA is preferred for BCG-vaccinated workers.

Bloodborne pathogen exposure: HIV post-exposure prophylaxis should begin as soon as possible, ideally within hours and no later than 72 hours, for a 28-day course; unvaccinated workers exposed to HBV receive hepatitis B immune globulin plus the vaccine series.

Heat-related illness: heat exhaustion involves heavy sweating, weakness, and cool clammy skin; heat stroke is core temperature 40 C or higher with central nervous system dysfunction and requires immediate cooling and emergency transport.

Case management documentation must distinguish work-related from non-work-related conditions, record objective findings, and maintain confidentiality of protected health information separate from the general personnel file.

OSHA incidence rate = (number of recordable cases x 200,000) / total employee hours worked; the 200,000 constant represents 100 full-time workers at 40 hours per week for 50 weeks.

DART rate = (cases with days away, restricted work, or job transfer x 200,000) / total employee hours worked.

Recording timelines: entries on the OSHA 300 Log are made within 7 calendar days of learning of a recordable case; a fatality is reported to OSHA within 8 hours and an in-patient hospitalization, amputation, or loss of an eye within 24 hours.

Recordability criteria: death, days away from work, restricted work or transfer, medical treatment beyond first aid, loss of consciousness, or a significant injury diagnosed by a physician or other licensed health care professional.

FMLA eligibility: 12 workweeks of unpaid leave per 12-month period requires 12 months of service, 1,250 hours worked in the preceding 12 months, and employment at a site with 50 or more employees within 75 miles.

ADA compliance: medical examinations may be required only after a conditional offer of employment; all medical inquiries of current employees must be job-related and consistent with business necessity, and records are kept in separate confidential files.

FTE calculation: FTE = total paid hours / 2,080; budget variance = actual expense minus budgeted expense, expressed as a percentage of budget.

Program return on investment = (net program benefit / program cost) x 100, and cost-benefit analysis compares total monetary benefits to total program costs.

Hierarchy of controls, most to least effective: elimination, substitution, engineering controls, administrative controls, then personal protective equipment.

OSHA noise exposure: permissible exposure limit 90 dBA as an 8-hour time-weighted average with a 5 dB exchange rate; a hearing conservation program including audiometric testing is required at an 85 dBA action level.

Respirator program requirements: medical evaluation before fit testing or use, annual quantitative or qualitative fit tests for tight-fitting respirators, and user seal checks each time the respirator is donned.

Permit-required confined space entry requires atmospheric testing before entry: oxygen between 19.5 and 23.5 percent, combustible gas below 10 percent of the lower explosive limit, and contaminant levels below exposure limits.

Hazard Communication requires a Safety Data Sheet with 16 standardized sections for each hazardous chemical, plus container labels with signal words and pictograms, and training before exposure occurs.

Bloodborne Pathogens standard: a written exposure control plan reviewed and updated at least annually, hepatitis B vaccination offered within 10 working days of assignment, and PPE provided at no cost.

Workers' compensation is a no-fault system covering injuries arising out of and in the course of employment; the exclusive remedy doctrine generally bars tort claims by the employee against the employer.

NIOSH lifting equation produces a recommended weight limit; the lifting index equals the actual load divided by the recommended weight limit, and a value above 1.0 signals elevated risk of lifting-related injury.

Transtheoretical model stages: precontemplation, contemplation, preparation, action, maintenance, with relapse possible; interventions are matched to stage rather than applied uniformly.

The Five A's counseling sequence for tobacco and other behavior change: Ask, Advise, Assess, Assist, Arrange follow-up.

Evidence hierarchy from highest to lowest: systematic reviews and meta-analyses of randomized controlled trials, individual RCTs, cohort studies, case-control studies, case series, expert opinion.

Sensitivity = true positives / (true positives + false negatives); specificity = true negatives / (true negatives + false positives); positive predictive value depends on disease prevalence.

Health Belief Model constructs: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy.

PICO format for clinical questions: Population, Intervention, Comparison, Outcome; it converts a practice problem into a searchable, answerable question.

Program planning logic model sequence: inputs, activities, outputs, short-term outcomes, intermediate outcomes, long-term outcomes; the evaluation design is selected before implementation.

Knowles' adult learning principles: adults are self-directed, problem-centered, internally motivated, and learn best when content is immediately applicable and builds on prior experience.