Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
UNIT 2A: ROLES & RESPONSIBILITIES IN ATHLETIC TRAINING CHAPTER 6: THE PRE-PARTICIPATION PHYSICAL EXAMINATION Sports Medicine 1 Ms. Whittington The Pre-Participation Physical Examination The pre-participation physical examination (PPE) has been an integral part of sports for decades GOAL IS TO HELP MAINTAIN THE HEALTH AND SAFETY OF ATHLETE! The Pre-Participation Physical Examination PPE: comprehensive assessment of: Overall health Ability to perform a sport at the highest level Emphasizes areas of concern in sports participation Identifies problem areas in athlete’s history The Pre-Participation Physical Examination Goals of the PPE Determine overall general health Identify defects that may limit participation Detect conditions that may predispose athlete to injury Determine optimal level of performance Fulfillment of legal & insurance requirements Evaluation of maturity level of younger athletes Evaluation of fitness & performance PRIOR to participation Opportunity to counsel youths regarding personal health issues Entry of athlete into a SM environment establish doctor/patient relationship The Pre-Participation Physical Examination Timing of the PPE should take place about 6 weeks prior to beginning of sport season ~ end of school year/mid-summer Allows time to further evaluate or treat discovered problems Most commonly examined in doctor’s office by 1 physician (typically your primary care doctor) 1. station-based PPE 2. office-based PPE The Pre-Participation Physical Examination Station-Based PPE Exam screens athletes by several different specialists responsible for specific aspects of the exam team approach Family physicians Orthopedic specialists Certified Athletic Trainers Physical therapists Podiatrists Pediatricians Cardiologists The Pre-Participation Physical Examination Station-Based PPE Exam Advantages Low cost Time efficient Athlete will see several specialists Disadvantages Recruitment of volunteer physicians, therapists, etc Facility space The Pre-Participation Physical Examination Office-Based PPE is completed at a traditional doctor’s office family physician Advantage…family physician has a complete history of the patient as a base for exam…quiet setting…review immunization history Components of the PPE Medical history is the most important aspect! identifies 75% of problems affecting athletes Helpful to have parents/guardians involved during process Key Concept PPE exam is needed to help identify athletes at risk of specific types of injuries and identify preventive techniques to avoid injury Relationship between athlete and physician Goal is to maintain the health and safety of the athlete Components of the PPE Baseline history information includes: Medical conditions/diseases Surgeries Hospitalizations Medications Allergies Immunization status Menstrual history Pulmonary status Neurologic status Musculoskeletal status Injures/illnesses since last exam Components of the PPE PPE is also a screening tool identify areas of concern Height Weight Pulse Blood pressure Eyes Ears/nose/throat Heart Abdomen Genitalia (males only) Skin Musculoskeletal Clearance for Participation in Sports Most important & difficult decision of the PPE…the decision of clearance Permission granted by a physician, based on an athlete’s physical examination to participate in a sporting event 3 categories 1. unrestricted 2. clearance after completion of further evaluation or rehabilitation 3. no clearance for certain types of sports or all sports Clearance for Participation in Sports How do physicians make the decision if there is an abnormality or condition found? Does it place the athlete at more risk of injury? Is another participant at risk of injury because of it? Can the athlete safely practice with treatment? Can limited participation be allowed while treatment is being completed? If clearance is denied for certain sports/categories, what activities can the athlete safely participate? Clearance for Participation in Sports Sports Categories/Classifications Divide sports into an area based on degree/level of contact or physical exertion Contact/Collision sports = HIGH RISK Limited contact = some risk Noncontact = low risk Table 6-2: Classification of Sports by Contact CONTACT/COLLISION LIMITED-CONTACT NONCONTACT Basketball Baseball Archery Football Gymnastics Bowling Boxing Horseback riding Crew/rowing Ice hockey Cross-country Discus, javelin, shot-put Lacrosse Softball Golf Soccer Volleyball Running wrestling Windsurfing/surfing Swimming Recordkeeping Information gathered through PPE must be made available to coaches, certified athletic trainers, and the athletic director STRICTLY CONFIDENTIAL! HIPAA Especially for pre-existing injuries, illnesses, conditions & allergies Secure location (office under lock & key) Kept for a minimum of 7 years Conclusion PPE has evolved over the past decade now a comprehensive approach to medical assessment of athletes PPE should be completed during pre-season Office or station-based evaluation Clearance is the most important step in any PPE Ultimate goal is to allow athletes to compete safely prevent sudden death in young athletes What is SCD? Sudden Cardiac Death (or Arrest) Condition in which the heart suddenly and unexpectedly stops beating Often cause an arrhythmia which inhibits normal blood flow through body Often the first sign that someone is suffering from SCA is fainting Why does it happen? Heart disease Physical stress Inherited disorders Long QT syndrome Abnormal pattern on an EKG Hypertrophic Cardiomyopathy Thinkening of heart muscles Typically the left ventricle Why should AT’s care about this? Because as far as I am concerned – this is the scariest thing that could happen while I am supervising an athletic event or practice!! Often there is no warning – people just drop dead So what’s the big deal? Should a cardiac screening be a part of all PPE’s? Advantages Save a life Not an invasive test Disadvantages Cost Time Please use complete sentences to answer the following questions… 1. 2. 3. 4. 5. What are the 3 major flaws the author finds with requiring athletes to get cardiac screening done? Cardiac screening will result in unavoidable deaths to those who undergo further tests – is this a reasonable risk to take just to save the same number of lives? Why or why not? How many Italian athletes are told they cannot participate after receiving their EKG? Is it acceptable to remove more athletes from sports to rule on the side caution? What is the stance of the American Heart Association on the cardiac screening of all athletes? Do you think we should require cardiac screening as part of all PPE’s done? Why or why not? (This should be at least 10 sentences long and well thought out)