In pre-participation screening, the personal and family history identifies more athletes at risk than the physical examination does. Questions about exertional chest pain, unexplained fainting, excessive breathlessness, a known heart…
In pre-participation screening, the personal and family history identifies more athletes at risk than the physical examination does. Questions about exertional chest pain, unexplained fainting, excessive breathlessness, a known heart murmur, and any family history of sudden death before 50 do most of the work. Forms filled in hurriedly in a car park undermine the entire exercise, which is why we send them ahead.
Height, weight, blood pressure and pulse. Cardiac auscultation both supine and standing, because some murmurs only appear on position change. Femoral pulses. Assessment for the physical features associated with Marfan syndrome. A musculoskeletal screen of the major joints, with attention to any joint the athlete has previously injured.
A pre-participation evaluation reduces risk; it does not eliminate it. Screening can miss conditions, and some cardiac conditions produce no signs until an event. We will not tell a parent that their child has been certified safe, because that is not what this is. What it does is find a meaningful proportion of the athletes who should be evaluated further before competing.
Cleared. Cleared with a condition - a brace, an activity limitation, a rehabilitation plan. Or not cleared pending further evaluation, which usually means an echocardiogram, an ECG interpretation by a cardiologist, or an orthopaedic opinion. The third outcome is the one the process exists for, and it should not be treated as a failure of the day.
Primary regulations and standards referenced above. Where a standard is published commercially it is named in full rather than linked to a copy.