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Prevention: Pre-Participation Physical Exams

Prevention: Pre-Participation Physical Exams. Annise Nalepa, ATC, LAT Tarleton State University. What is a PPE and why is it important?. H ow thorough are the physicals ? Is your paperwork really screening for all risk factors or is it just the bare minimum?

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Prevention: Pre-Participation Physical Exams

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  1. Prevention: Pre-Participation Physical Exams Annise Nalepa, ATC, LAT Tarleton State University

  2. 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.

  3. 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

  4. Personal Physician vs. Station Exam Personal Physician 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

  5. PPE different for each Population • Pre-Adolescent • Determine Life Threatening • Medications • Allergies • Congenital Abnormalities

  6. PPE different for each Population • High School • Screening by unfamiliar physicians • Determine minimum level of health • Heath education

  7. PPE different for each Population • College • Comprehensive health physical • Investment in athlete • Obtain PMH • Meet and Greet

  8. Components

  9. Vital Signs • Height • Weight • Vision • Blood Pressure • Heart Rate

  10. Personal History • Cardiac • Pulmonary • Neurological • Heart illness • Musculoskeletal • Allergies

  11. Physical Exam • Joint Flexibility/ROMs • Shoulder • Knee • Ankle • Hip • Trunk • Elbow • Wrist/Finger

  12. Orthopedic Clearance • Full Unlimited • Limited • Clearance Withheld Until… • No Athletic Participation

  13. Cardiac Concerns

  14. CardiacStats • 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

  15. 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 • PhysicalExamination • HeartMurmur • Femoral pulses to excludeaortic coarctation • Physicalstigmata of Marfan’s syndrome • Brachial arteryblood pressure (sitting position)

  16. Concussion History / Testing

  17. BESS Testing • Balance ErrorScoring System • Concussion Baseline • Inexpensiveyet time consuming

  18. ImPACT • Computer-based concussion baselinetesting • Expensiveyet efficient

  19. Natasha’s Law • Required Concussion training for Coaches and ATs • Physician Clearances • Education

  20. Education • www.cdc/concussion • Heads Up: Concussion in HS Sports • S/S • Management

  21. FormExamples

  22. OtherTopics: • Determine MD/DO/DC • Insurance • RequireSchoolIssuedForm for consistency

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