Athletes’ readiness to participate in activity is determined through a standardized pre-participation physical examination (PPE) screening process.
For nearly four decades a number of medical organizations have formalized the pre-participation physical examination (PPE).4, 5, 6 This PPE is meant to identify areas of concern in the health of the athlete which could contribute to impaired function during participation in athletics. This formalization creates a base framework for all health care providers to work from. No matter who is performing the PPE, they should all be held to the same standard outlined by the document. The PPE should be performed early enough before participation to ensure that any areas of concern can be addressed prior to beginning participation. Pre-participation physical exams should be conducted in accordance with local and state guidelines.
- The Inter-Association Task Force for Preventing Sudden Death in Secondary School Athletics Programs: Best-Practices Recommendations; Journal of Athletic Training 2013;48(4):546–553 https://www.nata.org/sites/default/files/preventing-sudden-death.pdf
- Advancing the Pre-participation Physical Evaluation: An ACSM and FIMS Joint Consensus Statement
- American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, American Academy of Pediatrics. PPE: Pre-participation Physical Evaluation. 4th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2010. https://www.aap.org/en-us/about-the-aap/Councils/Council-on-Sports-Medicine-and-Fitness/Pages/Preparticipation-Physical-Evaluation.aspx
- BOC Guiding Principles for AT Policy and Procedures
- NATA Secondary School Value Model
- National Athletic Trainers' Association Position Statement: Preventing Sudden Death in Sports; Journal of Athletic Training 2012:47(1):96-118 http://natajournals.org/doi/pdf/10.4085/1062-6050-47.1.96
- National Athletic Trainers’ Association Position Statement: Pre-participation Physical Examinations and Disqualifying Conditions; Journal of Athletic Training 2014;49(1):102–120 https://www.ncaa.org/sites/default/files/NATA-Position-Statement-PPEs-and-Disqualifying-Conditions.pdf
- Pre-participation cardiovascular evaluation for athletic participants to prevent sudden death: Position paper from the EHRA and the EACPR, branches of the ESC. Endorsed by APHRS, HRS, and SOLAECE.
- Screening for Sudden Cardiac Death Before Participation in High School and Collegiate Sports: American College of Preventive Medicine Position Statement on Preventive Practice
- Wingfield K, Matheson GO, Meeuwisse WH. Pre-participation evaluation: an evidence-based review. Clin J Sport Med. 2004;14(3):109–122. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3924614/
Hill v. Slippery Rock University, 138 A.3d 673 (PA Super. Ct. 5/3/16), 332 Ed. Law Rep. 361
In September, 2011 Jack Hill, Jr. was participating in a late-night, high-intensity basketball practice for Division II Slippery Rock University when he complained of feeling ill, and collapsed to the floor, unresponsive. Hill went into respiratory and cardiac arrest and passed away. Hemoglobin electrophoresis disclosed Sickle Cell Trait (“SCT”). The lawsuit alleged the negligence of Slippery Rock University, Slippery Rock University Health Center, and the nurse for not testing or requiring testing for SCT in pre-participation physical examinations. Hill completed a pre-participation physical questionnaire, which asked if the student-athlete had Sickle Cell Anemia (“SCA”) or SCT. Hill answered that he had neither SCA nor SCT, because he was unaware that he had SCT.
Although Division I schools required testing for SCT, Division II schools did not until 2012, and Division III schools until 2013. Relying partly on the fact that the questionnaire asked about SCA or SCT, but did not test for the presence of either, the Superior Court of Pennsylvania stated, “the incomplete medical clearance may have led Mr. Hill to believe that he was physically fit for basketball.” Finally, the Court held the lawsuit could proceed, as the plaintiffs sufficiently alleged that the medical and physical evaluations increased Mr. Hill’s risk of harm.