PREVENTION: PRE-PARTICIPATION PHYSICAL EXAMS Annise Nalepa, ATC, LAT Tarleton State University.
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Transcript of PREVENTION: PRE-PARTICIPATION PHYSICAL EXAMS Annise Nalepa, ATC, LAT Tarleton State University.
PREVENTION: PRE-PARTICIPATION
PHYSICAL EXAMS
Annise Nalepa, ATC, LAT
Tarleton State University
What is a PPE and why is it important?
• How thorough are the physicals?• Is your paperwork really screening for
all risk factors or is it just the bare minimum?
• Pre-participation physicals are a crucial part of physical health and determining if an athlete is healthy enough to compete.
• This seminar will discuss what should be included in a PPE and how you can make sure the athlete is safe.
Pre-Participation Physical Exams
Primary Detect Pre-disposing injuries Detect life-threatening/disabling
injuries Meet legal/insurance requirements
Secondary Determine general health Counsel health related issues Assess fitness levels
Personal Physician vs. Station Exam
(+)Access to medical record
(+)Know athlete Personally
(+)Can institute preventive care
(-)Time Consuming (-)Expensive (-)Not all PCP know
sports
(+)Faster (+)Economical (+)Fundraiser (+)Station Exam
(-)Physician unfamiliar with history
(-)Need to have someone review chart at end
Personal Physician
Station Exam
PPE different for each Population
Pre-Adolescent Determine Life Threatening Medications Allergies Congenital Abnormalities
PPE different for each Population High School
Screening by unfamiliar physicians Determine minimum level of health Heath education
PPE different for each Population College
Comprehensive health physical Investment in athlete Obtain PMH Meet and Greet
Components
Vital Signs
Height Weight Vision Blood Pressure Heart Rate
Personal History
Cardiac Pulmonary Neurological Heart illness Musculoskeletal Allergies
Physical Exam
Joint Flexibility/ROMs Shoulder Knee Ankle Hip Trunk Elbow Wrist/Finger
Orthopedic Clearance
Full Unlimited Limited Clearance Withheld Until… No Athletic Participation
Cardiac Concerns
Cardiac Stats
CVD Sudden Death in Athletes: (56%) 29% occurred in blacks 54% in high school students 82% with physical exertion during
competition/training 11% occurred in females
12 AHA Questions
Personal History Exertional Chest Pain/Discomfort Syncope/Near Syncope Excessive exertional and otherwise unexplained, dyspnea/fatigue associated
with exercise Previous recognition of a precordial murmur Elevated systemic BP Family History Premature death before age of 50 related to heart disease in one or more
relatives Disability from heart disease in a close relative less than 50 years old Specific knowledge of certain cardiac conditions in family members:
hypertrophic or dilated cardiomyopathy, long-QT syndrome or other ion channelopathies, Marfan’s syndrome, or clinically important arrhythmias
Physical Examination Heart Murmur Femoral pulses to exclude aortic coarctation Physical stigmata of Marfan’s syndrome Brachial artery blood pressure (sitting position)
Concussion History / Testing
BESS Testing
Balance Error Scoring System Concussion Baseline Inexpensive yet time consuming
ImPACT
Computer-based concussion baseline testing
Expensive yet efficient
Natasha’s Law
Required Concussion training for Coaches and ATs
Physician Clearances Education
Education
www.cdc/concussion Heads Up: Concussion in HS Sports S/S Management
Form Examples
Other Topics:
Determine MD/DO/DC Insurance Require School Issued Form for
consistency