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.”

Prevention Progression

June 28, 2015

The starting point for concussion care is prevention; and when we talk about prevention of concussions we must include education, equipment and enforcement.

Education is a shared responsibility of all who conduct and coach athletic programs; and the vital information about prevention, recognition, after-care and recovery needs to reach every player, their parents and all coaches.

Equipment is mainly the responsibility of those who make the protective gear and of those who make the rules specifications for that gear, but there are important responsibilities at more local levels. For example, to make sure what schools purchase and provide to players meets rules requirements, gets reconditioned as needed and fits properly. In football, for example, the fit of the helmet is much more important than its price ... fit at the start of the season and checked throughout the season.

As with education and equipment, enforcement is also a shared responsibility. In football it includes local enforcement of the 2014 football practice rules that have reduced collision practices; and in contests it means contest officials’ enforcement of the strongest set of safety rules in the game’s history.

In all sports, officials are to err on the side of safety; and when they do, the MHSAA will have their backs. Local school administrators and coaches should too.