Risk Management and the Pre-Participation Examination
Click the link below to read the NATA Position Statement about PPE and Disqualifying Conditions
http://www.nata.org/sites/default/files/Conley.pdf
The first piece of information that the athletic trainer should collect on each athlete is obtained from an intial preparticipation examination (PPE) before the start of the season. The primary purpose of the PPE is to identify an athlete who many be at risk before he or she participates in a specific sport. The six parts of the PPE include:
Medical History:
A medical history form should be completed before the PPE and orthopedic screening: its purpose is to identify any past or
existing medical problems. This for should be updated for each individual every year. Medical histories should be closely
reviewed by both the physician and the athletic trainer, so that personnel can be prepared, should a medical emergency arise.
Release forms and insurance information should be collected along with the medical history.
For an example of a medical history form, refer to this one from Duke Univeristy:
https://admin.xosn.com/pdf8/847475.pdf?DB_OEM_ID=4200&DB_OEM_ID=4200
Physical Examination:
The physical examination should include an assessment of height, weight, body composition, blood pressure, pulse, vision, skin, teeth,
ear, nose, throat, heart & lung functions, abdomen, lymphatics, urinalysis, and blood work if needed.
For an example of a physical examination, refer to page two of this form from the State of New Jersey Department of Education:
http://www.state.nj.us/education/students/safety/health/records/athleticphysicalsform.pdf
Cardiovascular Screening:
The critical task of the PPE cardiac examination is identifying life-threatening conditions. Although the cardiac examination need not
involve complex tests, it must permit the recognition of abdnormal heart sounds and other signs of pathology. The vast majority of
exams will be negative, but the physician should be alert to such potentially lethal conditions such as hypertrophic cardiomyopathy,
aortic stenosis, and Marfan's Syndrome. A history of symptoms during exertion, certain features of physical appearance, and clinical
findings require referral to a cardiologist.
Maturity Assessment:
Maturity assessment should be part of the PPE as a means of protecting examination as a means of protecting the young, physically
developing athlete.
Orthopedic Screening:
Orthopedic screening may be done as part of the physical examination or seperately by the athletic trainer. A quick orthopedic screening
usually takes about ninety seconds. A more detailed orthopedic examination may be conducted to assess strength, range of motion, and
stability at various joints.
From: Principles of Athletic Training by William Prentice, pg 55
Wellness Screening:
Some PPEs include a screening for wellness. The purpose is to determine whether the athlete is engaging in healthy lifestyle behaviors.
Commonly included are questions about tobacco, alcohol, and drug use, eating habits, fitness habits, and stress control.
(Prentice, 2010)
