Do we have enough PPE for our children?

By: Tami Dolphens, MPAS, PA-C
Nebraska Home Pediatrics
Creighton University PA Program
Omaha, NE

The abbreviation PPE has taken on new meaning in the last nine months. While “personal protective equipment” is the first thing on the mind of health care providers, parents, and even our children and teenagers, please don’t forget that PPE also stands for Preparticipation Physical Examination. 

Can you believe that the total number of athletes available for annual sports screening is close to 10 million? This includes 5 million high school athletes and half a million college athletes.

For years, the standard of care was that children and adolescents participating in organized sports should undergo a pre-participation (or Sports Physical) before each season begins. Twenty-five years ago, the American Heart Association released guidelines for preparticipation evaluation to screen young athletes for risk of sudden cardiac death. 

It was a well-researched, standardized, and proven approach to screening athletes at increased risk of sudden cardiac death.1  

More than 15 years later, a 2014 survey by Madsen et al. 2 suggested that <40% of providers were even aware of 14-point. A 2015 article published in the Journal of Pediatrics by Caswell et al. suggested that most state PPE policies do not adequately address the personal and family cardiovascular history questions necessary to identify athletes at risk for sudden cardiac death. Great strides have been made to improve compliance, and changes in the last few years has brought together the PPE with the well-child exam to improve comprehensive care and offer anticipatory guidance and immunizations, which otherwise could have been missed.  

In a time when fewer athletes are being screened, as demonstrated by a May 2020 Times Record News report, in which the State of Texas’ University Interscholastic League announces that only 1st-year athletes and athletes who answered yes to questions regarding recent injury or illness were required to complete a physical. The Coronavirus pandemic of 2020 has potentially undone the progress made by these organizations over the past few years. It is important that providers are diligent in their history taking and physical exam skills to avoid missing potentially life-threatening risk factors.


1. American Academy of Family Physicians, American Academy of Pediatrics, American College of Sports Medicine. Preparticipation Physical Evaluation. 4th ed. Elk Grove: American Academy of Pediatrics; 2010 

2. Madsen NL, Drezner JA, Salerno JC. The preparticipation physical evaluation: an analysis of clinical practice. Clin J Sport Med. 2014;24(2):142–149 

3. Caswell SV, Cortes N, Chabolla M, et al. State-Specific Differences in School Sports Preparticipation Physical Evaluation Policies. Pediatrics. 2015;135(1):26



See Tami Dolphens, MPAS, PA-C speak at the GAPA 2021 CME conference.

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