Prevention pre participation physical exams
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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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Prevention pre participation physical exams

Prevention: Pre-Participation Physical Exams

Annise Nalepa, ATC, LAT

Tarleton State University


Prevention pre participation physical exams

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

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

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


Ppe different for each population

PPE different for each Population

  • Pre-Adolescent

    • Determine Life Threatening

    • Medications

    • Allergies

    • Congenital Abnormalities


Ppe different for each population1

PPE different for each Population

  • High School

    • Screening by unfamiliar physicians

    • Determine minimum level of health

    • Heath education


Ppe different for each population2

PPE different for each Population

  • College

    • Comprehensive health physical

    • Investment in athlete

    • Obtain PMH

    • Meet and Greet


Components

Components


Vital signs

Vital Signs

  • Height

  • Weight

  • Vision

  • Blood Pressure

  • Heart Rate


Personal history

Personal History

  • Cardiac

  • Pulmonary

  • Neurological

  • Heart illness

  • Musculoskeletal

  • Allergies


Physical exam

Physical Exam

  • Joint Flexibility/ROMs

  • Shoulder

  • Knee

  • Ankle

  • Hip

  • Trunk

  • Elbow

  • Wrist/Finger


Orthopedic clearance

Orthopedic Clearance

  • Full Unlimited

  • Limited

  • Clearance Withheld Until…

  • No Athletic Participation


Cardiac concerns

Cardiac Concerns


Cardiac stats

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


12 aha questions

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)


Concussion history testing

Concussion History / Testing


Bess testing

BESS Testing

  • Balance ErrorScoring System

  • Concussion Baseline

  • Inexpensiveyet time consuming


Impact

ImPACT

  • Computer-based concussion baselinetesting

  • Expensiveyet efficient


Natasha s law

Natasha’s Law

  • Required Concussion training for Coaches and ATs

  • Physician Clearances

  • Education


Education

Education

  • www.cdc/concussion

  • Heads Up: Concussion in HS Sports

  • S/S

  • Management


Form examples

FormExamples


Other topics

OtherTopics:

  • Determine MD/DO/DC

  • Insurance

  • RequireSchoolIssuedForm for consistency


  • Login