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Medical Screening

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Preparticipation Physical Evaluation
Questionnaire: Yes No
1. Have you ever been hospitalized?    
2. Have you ever had surgery?    
3. Do you take any medications?    
4. Do you take any nutritional supplements?    
5. Do you have any allergies: food, insects, medicine, pollen?    
6. Have you ever been dizzy or passed out?    
7. Have you ever had chest pain?    
8. Do you have a heart murmur?    
9. Has any member of your family died a sudden death before age 50?    
10. Have you ever had a concussion, been knocked out, or become unconscious?    
11. Have you ever had a seizure/convulsion?    
12. Have you ever had a burner/stinger?    
13. Do you have asthma?    
14. Do you have any skin problems?    
15. Do you have diabetes?    
16. Have you ever broken/fractured a bone?    
17. Do you wear contacts?    
18. Do you have any dental appliances?    
19. Do you wear any special equipment to participate in sports?    
20. Have you had a tetanus shot within 5 years?    
21. Do you have nose bleeds?    
22. Do you have headaches?    
23. ♀: Is your menstrual cycle regular?    

Source: Anderson MK, Hall SJ & Martin M (2000); Lillegard WA, Burcher JD & Rucker KS (1999).

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Normal Vital Signs & Pathologies That Influence Them
Age Infant Child Adolescent Adult & Elderly Increases Due to: Decreases Due to:
T 98.2°F 98.6°F 98.6°F 98.6°F Infection, exercise, ↑ blood sugar ↓ hematucrit/ hemoglobin, narcotics, ↓ blood sugar, aging
HR 80–180 75–140 50–100 60–100 Infection, ↓ hematucrit/hemoglobin, ↓ blood sugar, anxiety, anemia, pain, ↓ K, exercise Narcotics, acute MI, ↑ K
RR 30–50 20–40 15–22 10–20 Infection, ↓ hematucrit/hemoglobin, ↑ blood sugar, pain, anxiety, asthma, acute MI, exercise Narcotics
SBP 73 90 115 <130 ↑ blood sugar, CAD, anxiety, pain, exercise (SBP only) ↓ hematucrit/ hemoglobin, ↓ K, narcotics, acute MI, anemia
DBP 55 57 70 <85

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Classification of Sports
Contact Noncontact
Collison Limited Impact Strenuous Moderate Nonstrenuous
Boxing Baseball Aerobic dance Badminton Archery
Field hockey Basketball Crew Curling Bowling
Football Bicycling Discus Sailing Cricket
Ice hockey Cheerleading Javelin Table tennis Golf
Lacrosse Diving Running   Riflery
Martial arts Equestrian Shotput    
Rodeo Fencing Speed skating    
Rugby Gymnastics Swimming    
Soccer Handball Tennis    
Water polo High jump Weight lifting    
Wrestling Pole vault      
  Skating      
  Skiing      
  Softball      
  Squash      
  Volleyball      

Source: Sports Medicine Secrets & NJ ...

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