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.”
Concussion Story
March 22, 2016
“The national narrative is not our story.” That’s been the mindset of the Michigan High School Athletic Association on many sports issues; and it’s never been more necessary than now, on the topic of concussions.
Hollywood’s December release of the movie “Concussion” and revelation after revelation of diseased NFL veterans tend to condemn professional football. But, in spite of its bad press, the NFL product roars on, setting records for its reach and revenue. Apparently the NFL is “too big to fail,” so critics of football attack an easier target – amateur, and especially, youth football. Other critics call for an end to football but swallow their whistle regarding boxing and even more barbaric ultimate fighting.
In sharp contrast, we hope, to the hypocrisy of the national narrative is the story of school sports in Michigan. We cannot speak for levels above or below us, but school-sponsored football has never been safer, for obvious reasons – the equipment has never been more protective; coaches have never received more health and safety training; playing rules have never been more safety-oriented; and officials have never had more authority to penalize unsafe play.
But in our story, football is not the only topic. Our health and safety narrative addresses all sports and both genders; and the 2015-16 school year provides three significant examples.
Mandated Concussion Reports – The MHSAA required for the first time this year that member high schools report possible concussions by their student-athletes. This is in all sports, both practice and competition, for both girls and boys. While reports are tentative for winter sports and it’s very early in the spring sports season, it is likely that in each case it will be a girls sport that has the most concussions, underscoring that school sports must be concerned about concussions in all sports and both genders.
Sideline Concussion Detection – The MHSAA last fall became the first state association to offer pilot sideline concussion testing, with 62 schools taking part in one of two programs. Among the objectives of the pilot programs was to increase awareness of concussions and improve sideline detection; and preliminary results indicate that the average number of possible concussions reported by pilot schools exceeds the average reported by schools outside the pilot group.
Concussion Care Insurance – The MHSAA also is the first state association to provide all participants at every member high school and junior high/middle school with insurance intended to pay accident medical expense benefits – covering deductibles and co-pays left unpaid by other policies – resulting from head injuries sustained during school practices or competitions. This coverage is at no cost to either schools or families.
While the insurance program will produce additional data about the frequency and severity of head injuries, the principal purpose of this initiative is to assure that families with no insurance, or insurance with high deductibles or co-pays, will not delay in seeking prompt, professional medical attention if their child shows signs of concussion after a practice or competition.
Again, this insurance is for all sports, both practice and competition, for both boys and girls; and it’s for all MHSAA member schools, grades 7 through 12. It will apply to the 6th grade for those school districts which join the MHSAA at the 6th-grade level, which is possible for the first time in 2016-17.