13 Foundational issues ational A Disqualifying Conditions thletic Trainers\' Ass

Question

13 Foundational issues ational A Disqualifying Conditions thletic Trainers' Association Position Statement: Pre-participation Physical Examinations and 1. 2. 3. 4. 5. What is the main purpose of the PPE? Is non-invasive cardiac testing a routine aspect of the PPE? What responsibilities do physicians have to athletes during the PPE? What is commonly used to test visual acuity in a physician's office or during a PPE in the ATR? At what point before a season is a PPE recommended to be completed before a season and why? 6. What questions should the physician ask himself/herself to determine if the athlete meets the criteria for participation? 7. What should the PPE include? (i.e. vital signs, etc.) 8. What could an ECG show as abnormal in a high proportion of normal athletes? 9. Why is baseline testing important during neurologic screenings? 10. Give a brief explanation of what sickle cell trait is, are all people who have the trait symptomatic, and which descent is sickle cell trait the most common? 11. What are the advantages and disadvantages of both getting a PPE done by a personal physician and a large scale PPE?

Explanation / Answer

5)4-6 weeks prior before the actual training.

6)Set of questions

1)To determine any false positive result.

2)Who will be responsible if the athlete collapse due to medical condition.

7)1. Medical and Family History

Personal History questions regarding chest pain, syncope( a sudden fall in heart rate causing fainting, fatigue, murmurs, blood pressure.
Family History questions regarding premature death, disability from heart disease and cardiac conditions in family members.
2. Physical Examination

General Health Screen
Vital signs, height, weight, blood pressure, vision testing, pulmonary, neurological, abdominal, skin and genitalia exam
Cardiovascular Screen
murmurs, femoral pulses, blood pressure
Auscultation of the heart in both seated and standing positions
Neurologic Screen
Sensory, reflex and motor control testing, concussion history, seizure disorder, spinal cord injury and cervical spinal stenosis Orthopaedic Screen
Musculoskeletal screening of previous and current injuries, site specific examination of strength, range of motion, deformity, and asymmetries
General Medical Screen
Signs and symptoms of or previous history of diabetes, anemia, and low ferritin levels my benefit from additional routine laboratory tests
3. Medication Use

Medications and supplements utilized should be assessed
4. Nutritional Assessment

Questions to determine the nutritional status and plan for disordered eating
5. Heat and Hydration Related Risk Factors

Screening of risk factors related to previous problems in the heat and review of guidelines for heat acclimatization
6. Metal Health Considerations

Questions to determine the mental status and a plan for referral should be initiated
8) Some common abnormalities in ECG in atheles are;

T wave inversion

Pathological Q waves

Sinus bradycardia

Atrial fibrillation

AV block

Right bundle branch block.

9)Neurological Baseline tests are required to assess an athlete’s balance and brain function (including learning and memory skills, ability to pay attention or concentrate, and how quickly he or she thinks and solve problems), as well as for the presence of any concussion symptoms.

10)Sickcle cell trait means having sickcle cell mutatated gene inherited from any of the parent.

Not all the people are symptomatic as only gene from one parent does not cause any problems but if both the parents have sickle cell trait the child can likely have sickle cell disease.

This disease is common in Africans, Afro Americans, Asians, Caucasians,Meditarian decent.

11)Personal doctor

Advantages:

a) Familiarity with the doctor can enable to complete the assessment without any hassle and can be very easy to complete.

b)Privacy: Doctors can provide privacy while counselling

Sensitive issues to their client with adequate time.

c)Continuity of care is possible.

Disadvantage:

a) Time constraints: A regular physician may allot less time to assess the client and can cause miss in diagnosing important medical condition.

b)Lack of expertise: Doctors may not have experience in assessing what is supposed to look out for in athletes.

c) Can be very costly.

Large scale PPE

Advantage:

Less cost

Less time

Disadvantage: No personal communication

Lack of individual attention

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