Question of the Week

May 14, 2007


Some schools have had reminders up for weeks or months. In order to be ready to participate in school sports for the next school year, now is the time to schedule a "preparticipation physical examination."

"In the sports medicine field, the sports physical exam is known as a preparticipation physical examination (PPE). The exam helps determine whether it's safe for you to participate in a particular sport. Most states actually require that kids and teens have a sports physical before they can start a new sport or begin a new competitive season. But even if a PPE isn't required, doctors still highly recommend them. ... There are two main parts to a sports physical: the medical history and the physical exam. ..."
Kids Health

The medical history form is one that students should fill out by talking with both parents, if at all possible. The physical exam may vary based on the gender and specific health status of each potential athlete.

Even with information about the student's family history and a physical exam, some health conditions go undetected until there is a problem.

"A 13-year-old girl who died after becoming ill at track practice was the third teenager to die this spring in Wisconsin during a track workout. ... Alysa Sadowski, a seventh-grader, had finished a run during the last practice of the season Wednesday and complained she wasn't feeling well. When Sadowski didn't have the strength to walk, team members alerted the coaches. They called an ambulance and the girl's mother, Childs said. Sadowski died later, apparently of cardiac arrhythmia ... Adam Luing, a high school junior, died April 17 after collapsing during track practice in Ontario ... Jason Schultz, a senior at Stevens Point Area High School, collapsed after running sprints with other shot putters during a practice and complained of not feeling well. He was rushed to a hospital but couldn't be revived. ..."

School districts are looking for ways to reduce the likelihood of such tragedies.

"Some schools may require that a PPE include an electrocardiogram, or EKG, for all athletes. An EKG, which takes about 10 minutes, measures the electrical activity of a person's heart. EKGs don't hurt -- electrodes that measure heart rate and rhythm are placed on the chest, arms, and legs, and a specialist reads the results."
Kids Health

Preventative measures (such as a PPE and EKG) help doctors, parents, athletes, and coaches make educated decisions about whether or not they think it will be safe for the athlete to participate in a given sport.

Unfortunately, no screening is perfect, and there is still the chance of a medical emergency. For this reason, schools try not only to prevent, but to prepare.

"* Each student-athlete must have a current (within one calendar year) medical certificate on file before the first day of participation (tryouts, practices).
* A physician must be present prior to the start of all football games (league and non-league) and must be present until the completion of the contest. ...
* A PSAL [Public Schools Athletic league] authorized football teacher/coach (with current AED, First Aid and CPR certifications) must be present at every game, practice and scrimmage. A defibulator must be on the field for every practice and game.
* Both teams are responsible for having their defibulators on site in the bench area!"
Public School Athletic League

Within the past few years, AEDs have become more and more common, even to the point of being required at most sporting events and some practices.

"An automated external defibrillator (AED) is a portable automatic device used to restore normal heart rhythm to patients in cardiac arrest. An AED is applied outside the body. It automatically analyzes the patient's heart rhythm and advises the rescuer whether or not a shock is needed to restore a normal heart beat. If the patient's heart resumes beating normally, the heart has been defibrillated. An AED is used to treat cardiac arrest. It is a life-saving device because cardiac arrest is a sudden condition that is fatal if not treated within a few minutes."
U.S. Food and Drug Administration

For many, cardiac arrest is a condition they associate with older adults, not with those in their teens and early 20s who are participating in jr. high, high school, and college sports.

"DALLAS, April 3, 2007 – Sudden cardiac arrest (SCA) affects more than 400,000 people annually in the United States and is the leading cause of death among young athletes. ... 'Unfortunately sudden cardiac arrest can be mistaken for other causes of collapse, which can lead to treatment delays,' said Ron Courson, ATC, task force co-chairman.� 'Increased training will help rescuers correctly identify SCA and prevent critical delays in beginning resuscitation. In fact, access to defibrillation within three to five minutes is essential, because each minute lost reduces the chance of survival by approximately 10 percent.' "
National Athletic Trainers Association

If people at the scene do not think to associate SCA with young athletes, then treatment time can be lost and the chances of saving the patient decrease.

With so many possible things that could go wrong, and so many individual variables, those involved with school sports are being asked to know and do more and more to help create the safest possible environment.

"First and foremost every institution that sponsors athletic activities is urged to have a written and structured emergency action plan (EAP) in place... The key to successful treatment for SCA begins with appropriate emergency preparedness, CPR and AED training for all likely first responders, along with access to early defibrillation. Essential components of SCA management include early activation of EMS, early CPR, early defibrillation and rapid transition to advanced cardiac life support. In fact, any collapsed and unresponsive athlete should be managed as a sudden cardiac arrest with application of an AED as soon as possible for rhythm analysis and defibrillation if needed."
National Athletic Trainers Association

Questions of the Week:
What do you need to know about your own health and medical history before deciding whether or not to participate in school sports? What do you need to do to get this information? What emergency response procedures does your school have set up to deal with health issues that would need immediate attention at a school sponsored game, meet, or practice? What should the athletes know about these procedures? What should the coaches know? Parents? Spectators? What can you do to educate those around you and create the safest possible school sports environment?

Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

Health Community Coordinator
Access Excellence @ the National Health Museum

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