//fpnotebook.com/
Pre-participation History
Aka: Pre-participation History, Preparticipation History, Sports History
- See Also
- Preparticipation Physical Evaluation
- Pre-participation Exam
- Pre-participation Special Circumstances
- Station Divided Sports Physical
- Sports Participation Disqualifiers
- Sports Contact Levels (Contact Sport or Collision Sport)
- Sports Intensity Levels (Dynamic Sports, Static Sports)
- Athletic Heart Syndrome
- Arrhythmias in Athletes
- Sudden Death in Athletes
- Background
- Sports History is the most important part of the preparticipation evaluation
- Detects 88% of general conditions, and up to 75% of musculoskeletal conditions
- Cardiovascular symptoms (e.g. Exertional Syncope, Chest Pain)
- Among the most important screening questions and the initial impetus for the preparticipation evaluation
- Core cardiovascular screening questions are derived from consensus guidelines (e.g. AHA 14)
- Petek (2020) Curr Emerg Hosp Med Rep 8(3): 77-89 +PMID:33552703 [PubMed]
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7863976/
- Sports evaluation is an important contact point address important but neglected psychosocial pitfalls
- Mental health screening (e.g. Major Depression, Anxiety Disorder, Substance Abuse, Eating Disorder)
- History: General
- Any new changes in the next year
- Hospitalized or surgery
- Missing parts (unpaired organs)
- Prior sports preparticipation disqualification
- Medical problems
- Diabetes Mellitus
- Mononucleosis (related to Splenomegaly)
- Hepatitis
- Human Immunodeficiency Virus (HIV)
- History: Medication (prescribed and over the counter)
- General Medications
- Insulin
- Anticonvulsants
- Antihistamines (Heat Injury risk, Arrhythmia risk)
- Doxycycline (Sunburn risk)
- Oral Contraceptive use
- Inhaled Bronchodilators
- NSAID use and over use
- Ergonomic aids (Performance supplements)
- Weight loss drugs (e.g. Ephedra or Ephedrine)
- Anabolic Steroids
- Megavitamins
- Creatine
- History: Allergy
- Medication allergies
- Allergic Rhinitis to Pollens
- Anaphylaxis or allergy to Stinging Insects or food
- Need for epi-pen?
- Exercise induced Urticaria
- History: Pulmonary
- Diagnosis of Exercise induced Asthma or bronchospasm
- Cough during or after Exercise
- Excessive or unexplained Shortness of Breath during or after activity (exertional Dyspnea)
- History: Cardiovascular
- Exertional Syncope or unexplaned Syncope (Blackout, Dizziness)
- Hypertrophic Cardiomyopathy
- Asthma
- Premature Coronary Artery Disease or coronary anomaly
- Exertional Chest Pain, chest tightness or chest pressure
- Easily Fatigued
- Overtraining
- Acute or chronic illness
- History of Heart Murmur (e.g. Congenital Heart Disease)
- History of Hypertension or elevated Blood Pressures
- History of Palpitations (Arrhythmia)
- Benign (sinus): Gradual onset and better on exertion
- SVT: Sudden onset very fast rate, resolved with vagal
- Ventricular Tachycardia (e.g. long QT Interval)
- Drugs: Tobacco, Caffeine, Alcohol, drugs, supplements
- Viral Infection in last month (Myocarditis)
- Prior medical provider ordered a cardiac evaluation study
- Prior disqualification for heart problem
- Family History of Sudden Cardiac Death
- Under age 50 years
- Premature Coronary Artery Disease
- Dilated Cardiomyopathy
- Under age 30 years
- Hypertrophic Cardiomyopathy
- Anomalous Coronary Artery
- Marfan's Syndrome
- Long QT Syndrome
- Genetic cardiac conditions or ion channel channelopathies
- History: Neurologic
- Concussions: Knock-outs, Unconscious, Concussion
- See Concussion in Sports
- Number of lifetime Concussions
- Recent Head Injury
- Severity of each Head Injury
- Seizure history
- Is condition controlled?
- When was last Seizure?
- Anticonvulsants
- Neck injury or cervicobrachial injury (e.g. Brachial Plexus Injury)
- Have you had a Burner, Stinger or pinched nerve?
- Spinal stenosis
- Have you ever had extremity numbness or tingling?
- History: Environmental Injury
- History of Heat Injury
- Heat Cramps
- Heat Exhaustion
- Heat Stroke
- Discuss Hydration and Heat Injury prevention
- Discuss risk of future Heat Injury
- History: Musculoskeletal Injury
- Joint Injury, Joint dislocation or joint subluxation
- Ligamentous Sprain
- Tendinous Strain
- Prior Fractures
- Persistent dysfunction
- History of rehabilitation program
- Special equipment use for injury prevention
- Knee Braces
- Neck rolls
- Foot Orthotics
- Hearing Aids
- History: Eye
- Eye or Vision problems
- Eye loss
- Eye Protection
- Vision must be corrected 20/40 or better to participate
- Eye Glass or Contact Lens use
- Protective eyewear (Single eye)
- History: Immunization
- Immunizations current?
- Tetanus Vaccine (Td) at age 12 or 16
- Measles Mumps Rubella (MMR) twice
- Consider additional Vaccinations if not pregnant
- Varicella Vaccine if indicated
- Hepatitis B Vaccine
- History: Menstrual
- Menarche
- Last Menstrual Period
- Longest time between periods
- Number of Menses in last year
- History: Weight
- See Female Athlete Triad
- See Relative Energy Deficiency in Sport (RED-S)
- See Childhood Obesity
- Current weight
- Highest weight in last year
- Lowest weight in last year
- Ideal Weight
- What would you like to weigh?
- Red Flags for Eating Disorder and Anabolic Steroid use
- Low weight for expected Ideal Weight
- Recent excessive weight loss
- Recent rapid weight gain
- History: Social
- See HEEADSSS Mnemonic
- Stress Confidentiality!
- Family problems
- Alcohol use
- Tobacco Abuse or Vaping
- Illicit Drug use and Drug Abuse
- See Adolescent Drug Abuse
- See Drug Abuse in Athletes
- See Sports Performance Supplement
- Are you stressed out?
- Any problems in school or with friends?
- Bullying
- Any need for Contraception
- Gender Identity
- State regulations vary regarding if participation is based on biologic gender or identity
- See Transgender Person
- Sexually active?
- Sexual Abuse
- Sexually Transmitted Disease discussion
- Need barrier Contraception (Condoms)?
- Safety Issues: Seat Belt, Bike Helmet
- Resources
- Preparticipation History
- https://www.aap.org/en-us/Documents/PPE-History-Form-%28English%29.pdf
- Preparticipation History Addendum for Athletes with Disability
- https://www.aap.org/en-us/Documents/PPE-Athletes-with-Disabilities-Form.pdf
- Preparticipation Exam
- https://www.aap.org/en-us/Documents/PPE-Physical-Examination-Form.pdf
- Preparticipation Medical Eligibility
- https://www.aap.org/en-us/Documents/PPE-Medical-Eligibility-Form.pdf
- References
- Kurowski (2000) Am Fam Physician 61(9): 2683-90 [PubMed]
- MacDonald (2021) Am Fam Physician 103(9): 539-46 [PubMed]
- Mirabelli (2015) Am Fam Physician 92(5): 371-6 [PubMed]