ESSAY: 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.
Case #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”.
Based on Case #5,
• Answer the following questions:
o Would you clear George?
o Why or why not?
o Are there any specialists George needs to see before clearance?
o What are some of the preventive measures you would discuss with George and his father related to playing sports, specifically football?
• Please insure your references are (preferably) within 3 years and no older than 5 years.

ANSWER

Pediatric Health Maintenance Exam and PPE

The primary goal of performing a PPE is to promote the safety and health of George. The PPE gives medical history on which physician and other related medical staffs make physical activity decisions.  The effectiveness of pediatric health care is dependent on services of various experts including surgical specialists, medical subspecialists, pediatric physicians, nurse practitioners, and physician assistants (Piel, Steinberg & Rees, 2017).  George, a 12-year-old male has sickle cell trait, which does not cause any symptoms or disease. Therefore, it is not considered as a barrier to exercising or participating in sports. Based on his previous health maintenance exam, I would clear him to start football practice. However, it will be important to implement universal precautions for his safety and health, irrespective of his sickle cell status. Implementation of universal precautions would assist in avoiding circumstances that may expose George to exercise-related injuries.

The clearance process would also rely on evaluation results from other pediatric specialists including pediatric gastroenterologists, pediatric neurologists, and pediatric cardiologists. Another factor to consider is the nature of the physical sport that George wants to participate. Therefore, the additional physical examination should be carried out to assess the child’s hearing, visual, and the cardiovascular and musculoskeletal abilities (Conley et al., 2014). In this case, the most abnormal PPE results that are likely to alter my decision is the presence of high blood pressure and ocular hypertension.  Therefore, if there are no other identified health complications, I would issue an unrestricted clearance to George. The child will be conditionally cleared if there are pending results of some tests. A discussion with George’s parents regarding his ability to play football and relevant precautionary measures to take will be critical. This will be important…