Cardiac Screening
October 31, 2014
Sudden death among 12 to 25-year-olds is “a low event rate occurrence.”
“There is insufficient information to support the view that ECGs in asymptomatic young people for cardiac disease is appropriate or possible on a national basis for the United States, in competitive athletics or in the general population.”
“At present, there is no mechanism available in the United States to effectively create national programs of such magnitude, whether limited to athletics or including the wider population of all young people.”
“There is insufficient evidence that particularly large-scale/mass screening initiatives are feasible or cost effective within the current US healthcare infrastructure . . .”
“The ECG . . . cannot be regarded as an ideal or effective test when applied to large healthy populations.”
“An additional, but unresolved, ethical issue concerns whether students who voluntarily engage in competitive athletic programs should have advantage of cardiovascular screening, while others who choose not to be involved in such activities (but may be at the same or similar risk) are in effect excluded from the same opportunity.”
The AHA’s Sept. 14 AHA writing group “does not believe the available data support significant public health benefit from using the 12-lead ECG as a universal screening tool. The writing group, however, does endorse the widespread dissemination of automated external defibrillators which are effective in saving young lives on the athletic field and elsewhere.”
Best Practices
June 28, 2016
Two-thirds of concussions reported in Michigan high school football last fall occurred in games. Even though there are at least five times more hours of exposure during practices than games, there are half as many concussions during practice, according to the mandated concussion reporting requirement of the Michigan High School Athletic Association that is unmatched in the country in terms of its depth and breadth for a statewide requirement.
Michigan was among the handful of states to restrict contact in practice, in 2014, a full season prior to recommendations from the National Federation of State High School Associations and later action by most other statewide associations.
Some of those statewide organizations continue to operate without limitation on contact in football practices, while their counterpart organizations in other states have gone so far as to limit contact to a certain number of minutes in a day and/or week.
Entering mostly uncharted waters for high school football in early 2014, an MHSAA task force recommended that the number of practices be limited where collisions between players could occur – no more than one per day during preseason, no more than two per week after the first game.
This change was embraced by this state’s football coaches association and adopted by the MHSAA Representative Council. All parties liked the ease of administration of this policy, and all distrusted the idea of limiting the number of minutes of contact during practices.
If there is a 30-minute limit on contact in a day or a 90-minute limit on contact in a week, is it the same 30-minute or 90-minute period for all players, even if many are not involved in one or more of the contact drills? Or does the limit apply to each player individually; and if so, how is that tracked, and by whom?
These and other questions made coaches and administrators question how effective a limit on minutes might really be. Nevertheless, a 90-minute per week limit during regular season has been made an MHSAA recommendation for the 2016 season. This will provide an opportunity to address and possibly answer some of the questions that have been raised.
The MHSAA will survey schools this fall about their practice plans and the actual time spent in contact drills by players, assessing how that differs according to offense, defense, player position and grade in school, and determining best practices for how to track player contact minutes.
When Michigan acted in 2014 to limit contact in practice, it was one of the first states to do so. As Michigan takes additional steps to limit contact in practice, it will be one of the first states to do so after researching the best ways to actually do it.