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.”

Concussion Care Continuum

June 2, 2015

The concussion care continuum is of equal importance from start to finish, but some of the stops along the way are more in the MHSAA’s area of influence than others, so they are receiving more of our attention.
We would never say that removal-from-play decisions are more important than return-to-play decisions. However, because the removal decisions occur at school sports venues by school-appointed persons, while the latter are made at medical facilities by licensed medical personnel selected by students’ families, the MHSAA is giving the removal process more attention than the return.
This helps to explain why the MHSAA is orchestrating pilot programs where volunteering member schools will be testing systems during the 2015-16 school year that may assist sideline personnel at practices and contests when assessing if a concussion event has occurred and that player should be withheld from further activity that day. The buzz that these pilot programs is creating will increase everyone’s attention on improving sideline concussion management. For more information, click here.
The MHSAA has always believed it shared a role with local schools and health care facilities and professional organizations of coaches and school administrators in the education of coaches, athletes and parents. This remains our first and foremost focus on the concussion care continuum.
But the pilot programs, and more specific requirements beginning in 2015-16 to report head injury events, demonstrate that the MHSAA is moving further along the continuum to assist the entire concussion management team. As we do so, our focus is on all levels of all sports for both genders, grades 7 through 12, with attention to both practices and competition.