1. Pre-Participation Physical Examination
Organization and Administration of Athletic Training

2. Ch. 10 Worksheet
Due Thursday 12/1 before class

3. Pre-Participation Physical Exam
PPE – why?
Injury/illness prevention
History – look for red flags – ACT ON THEM
Education/counseling – might be your only opportunity to educate them on proper healthy habits

4. PPE Office exam Group/Station exam – one large session
Individual appointment
Group/Station exam – one large session
Check in – medical history
Height and weight
Vision
Blood pressure/pulse
Orthopedic screening – x-rays, MRI if necessary?
Physician’s examination
Urinalysis? Blood work? Echo?
Fitness testing
Wingate? VO2 max?
Check out

5. PPE – Office vs. Group/Station
Office exams
Strengths
Greater privacy
Easier access to patient records
Easier access to medical supplies/equipment
More conducive to counseling
Athlete has freedom to choose physician

6. PPE – Office vs. Group/Station
Office exams
Weaknesses
Greater potential for breakdown in communication to school/university sports medicine personnel
Greater potential for lack of familiarity with specific sport demands
Less efficient
Difficult to incorporate fitness testing

7. PPE – Office vs. Group/Station
Group/Station exams
Strengths
Greater efficiency
Easier access to whole sports medicine team
Easier to include fitness testing
Fundraiser?

8. PPE – Office vs. Group/Station
Group/Station exams
Weaknesses
Little to no privacy
Difficult to counsel
Can be noisy – disorganized
Need the help of volunteers
Need accommodating facilities
Athletes’ records are usually not readily available

9. PPE
Again, don’t just go through the motions just to collect information - USE the information and follow up with areas of concern/red flags

10. PPE
What if someone is not cleared to participate and makes it clear that they intend to participate anyways?
Remote/small high school – AMA waiver form?
Larger high school/college – sports medicine team should not allow it
Good communication with coaching staff/athletic department

11. PPE Case Study

12. Drug Testing

13. Drug Testing
Random by sport
Random by position
Random by playing time
Random by scholarship
Random – no notice/some notice
Reasonable suspicion
Specific signs of drug use/abuse
List of banned substances – NCAA

14. Drug Testing Methods Enzyme multiplied immunoassay technique (EMIT)
Analyzes light absorption in urine
Positive tests must be confirmed with Gas chromatography-mass spectrometry
Less expensive than GC-MS

15. Drug Testing Methods Gas chromatography – mass spectrometry (GC-MS)
Gold standard in urinalysis
Highly accurate in detecting performance enhancing drugs
More expensive than EMIT
Analyzes for “fingerprints” of banned substances

16. Drug Testing Must be observed
Yes, actually observed
Stage fright?
Try caffeine/alcohol-free beverages (sealed)
Won’t affect results – may help produce sample
Should be tested through a disinterested third party
False positive vs. false negative?
Scare tactic?
Knee-jerk reaction?

17. Drug Testing (disclaimer!!!)
Temperature? Specific gravity?

18. Drug Testing
Well-designed programs contribute to strengthening the legal foundation of drug testing
Testing performed by an outside agency
National Center for Drug Free Sport
Privacy of those being tested/having tested positive
Limited number of people who have this information
Opportunity to disclose medications that may interfere with testing
Retest for positive tests
Positive test bans athletes from athletics, not school

19. Drug Testing Guidelines
Clearly articulate the purpose of the program
Make testing as sport-specific as possible
Use valid and reliable methods
Incorporate an appeal mechanism
Protect the athlete’s privacy

20. Drug Testing Guidelines
Develop written policies/procedures
Obtain consent
Inform potential and current athletes
Train and retrain personnel