Preparticipation screening of high school athletes: are recommendations enough?

The American Heart Association (AHA) recommends cardiovascular screening and injury history for all student-athletes to prevent sudden cardiac death and related problems. No standard preparticipation physical evaluation (PPE) form is currently required, and the qualifications of those who perform these evaluations vary.

To assess the PPE process of high school student-athletes in Oregon.

A survey was mailed to the athletic directors at 258 Oregon high schools that were members of the Oregon Schools Activities Association (OSAA) and had interscholastic athletic programs for the 1999-2000 school year. Directors were asked to complete the survey and return it with a copy of the PPE form they used if they were not already using the recommended form.

Responses were received from 154 (60%) of the 258 high schools surveyed. Seventy-five (53%) of the 142 forms evaluated contained fewer than 5 of the AHA recommendations for cardiac screening. Forty-two schools (27%) were implementing the PPE form recommended by the OSAA.

Most Oregon high schools were not adequately screening student-athletes for injury history or for cardiovascular conditions as recommended by the AHA. We recommend required use of an approved PPE form and specific guidelines for healthcare providers who perform the exam.