Cardiac Screening

October 31, 2014

The American Heart Association has once again concluded that sophisticated and expensive heart screening is not practical or appropriate as a precondition for youth and young adults to participate in competitive organized sports.
On Sept. 14, 2014, the AHA online publication Circulation stated:

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.”

Kicking Bad Habits

May 4, 2018

Forty years ago, as a youngster on a venerable staff at the national office of the National Federation of State High School Associations, where the playing rules for high school football were published, I would entertain my colleagues with a quixotic proposal – year after year – to eliminate the kickoff from football.

As a college player, I got my first playing time as a member of the kickoff team. I knew it was because the coaches didn’t want to risk injury to better players.

As a high school coach, when I conducted preseason scrimmages, I always insisted that kickoffs not occur because I didn’t want to risk season-ending injuries before the season even began.

So, as the world of football from youth levels to the pros is eliminating kickoffs or altering rules to reduce their frequency, I write smugly, “What took you so long?”

Rules committees on every level for every sport have an obligation to examine the data for their sports closely and determine precisely the circumstances that cause the most injuries. And then they must create and enforce rules that will eliminate or greatly modify that most injurious situation.

If the data tells us now what my gut told me as a young coach and administrator, we should give kickoffs the boot.