ESSAY : Pediatric Health Maintenance Exam and PPE

Pediatric Health Maintenance Exam and PPE

The foundation of pediatric healthcare visits, both sick and well, starts with a thorough health history; from the data collected, an accurate physical examination and diagnosis can be made. Primary care healthcare visits are an integral part of ensuring the health and well-being of the child. In children that participate in sports, a preparticipation physical examination (PPE) is required and may be the only contact the healthy child has with their healthcare provider.

Topic 5: George is a 12-year-old male brought to the clinic by his father and wants to start playing football and needs a preparticipation physical examination (PPE). He is an established patient in your practice and his last health maintenance exam was at 11 years of age. In reviewing his health history, you note that he has sickle cell trait but otherwise healthy. During his exam, you auscultate a Grade I murmur, and the remaining exam is normal. Dad asks if you will clear George to start football practice tomorrow. Would you clear George? Why or why not? Are there any specialists George needs to see before clearance? What are some of the preventive measures you would discuss with George and his father related to playing sports, specifically football?

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SAMPLE SOLUTION

George, a 12-year-old male student portrays sickle cell trait, which is not considered a disease or a barrier to participating or exercising in sports. Therefore, I would clear George to start football practice. However, the implementation of universal precautions will be fundamental to protect his safety and health, regardless of his sickle cell trait status. Implementing universal precautions to George and all patients with sickle cell trait would help in avoiding circumstances that may predispose them to exertion-related injuries. These protection measures will be relevant in the management and prevention of various medical conditions. In addition, clearance would also depend on evaluation result from other pediatric specialists and the type of sport that George wishes to participate. Further physical examination should be done to include assessment of vision, hearing, and the musculoskeletal and cardiovascular systems. The most common abnormal PPE findings that are likely to affect George include blood pressure and elevated vision problems…