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.”
Upon Further Review
November 6, 2015
Michigan was among the first dozen statewide high school associations in the U.S. to reduce the amount of contact during football practices. Since Michigan acted prior to the 2014 football season, the National Federation of State High School Associations has adopted recommendations, and all remaining state high school associations have adopted new restrictions.
The task force that acted early in Michigan to make the proposals that were supported by this state’s football coaches association and the MHSAA Representative Council wanted policies that could be clearly understood and easily enforced. The task force concluded that counting minutes of contact during a practice or a week was not the best approach.
Who would track the minutes for each and every player? Does the minute of contact count for a player who is only observing and not actually participating in the contact drill or scrimmage?
In limiting Michigan teams and players to one collision practice a day prior to the first game and two collision practices per week the rest of the season, the task force recommendation avoided the need to have coaches and administrators track and record the minutes of each and every player on each and every team each and every day and to determine what types of activities and what degree of involvement counted against 30- or 60- or 90-minute maximums.
It is anticipated that the MHSAA Football Committee will review in early 2016 what other states have done since the MHSAA acted in early 2014, but it is not assumed that changes are needed to existing practice policies. Further review may confirm earlier judgments about policies that are both protective of players and practical for coaches and administrators.