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.”

Small Steps

November 3, 2015

“You can’t cross a chasm in two small jumps.” I believe it was former British Prime Minister David Lloyd George who said this when advocating for a big leap forward for his country during the early 20th century.

Indeed, taking two small jumps when one giant leap is necessary is an ill-fated strategy.

However, I have found that a series of smaller steps to solve large problems is very often the most practical and politically-expedient approach.

For example, as we have enhanced coaching requirements, especially related to health and safety, we didn’t insist that all of the changes occur simultaneously, or immediately. One thing at a time, phased in over several years, made these changes possible.

My MHSAA colleague Rob Kaminski, our webmaster and publications coordinator who is also an MHSAA registered football and basketball official, once remarked, “Not all football plays are designed to score touchdowns; some are just intended to move the ball forward or to set up a bigger play later.”