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.”
The Next Big Thing
February 16, 2016
The full-time athletic director, without a lot of other duties and with support for clerical matters as well as event supervision, is a situation rarely seen in secondary schools today. That’s bad for students, schools and school sports.
Today, typically the athletic director’s job is divided among many areas of a school’s operations. And when a veteran athletic director retires, moves up or otherwise moves on, it is typical that the “replacement” is an inexperienced person who is given even more to do with less time to do it.
So, when I asked the MHSAA Representative Council in December to talk about and commit to writing what it believes is the “next big thing” the MHSAA should be doing, it was not surprising to me that the consensus was this: “We should be conducting much more Athletic Director In-Service training, both in person and electronically, for both new ADs and veterans; and we shouldn’t shy away from a ‘back-to basics’ approach, with testing.”
The theme of the responses of Representative Council members in December was that as schools are becoming increasingly under-resourced, the MHSAA must do more. Clearly, the Representative Council (as a group) has lower expectations for what schools can do for themselves, and higher expectations for what the MHSAA should be doing to help schools. If there is a worry in all this, it is that the Representative Council is losing confidence in the principle of “institutional control,” and the Council sees the need to place increasing demands on the MHSAA to train, oversee and actually do things that would have been an overreach of our proper role 20 or even 10 years ago.
The transformational idea here – I don’t like it, but perhaps it’s unavoidable – is that the MHSAA must do more because of the reality that overburdened, under-resourced school personnel can only do less. And, if we fail to do more, school sports will continue to create problems for itself, and worse, continue to drift to a point where school sports are barely distinguishable from non-school sports programs.
We are seeing building athletic directors less engaged in the administration of school sports and, in their place, local administrators are depending on third parties to schedule games and assign officials, or they are delegating scheduling and most administrative details to their coaches, an increasing number of whom are nonfaculty members who have more affinity to non-school sports than school sports. This isn’t just happening in skiing, golf and bowling but also in basketball and other sports.
As we inventory the controversies we’ve endured this past fall, we see that in almost every case there was a lack of knowledge or execution at the local level that created a problem which people then were all too ready to blame the MHSAA for. The policy or the organization gets criticized for an individual’s deficient attention or action at the local level. And every controversy is a distraction – it gets in the way of our work, and it adversely affects our ability to convey a positive message about the important role of educational athletics in the lives of students, schools and society.