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 First Time
April 3, 2018
I remember as clearly as if it were yesterday the first time I had to determine a student was not eligible under rules of the Michigan High School Athletic Association.
At that singular moment, it did not matter that I had been able to advise a dozen previous callers that the students they were inquiring about were eligible under the rules. All I could see in my mind’s eye was this one student who would not be able to participate as a full-fledged member of a team in a sport he enjoyed.
I assumed, as I have in almost every case since, that this was a “good kid,” and one who needed sports more than sports needed him.
But the facts made him ineligible and there were no compelling reasons to look beyond the facts. I knew it would be hard on the student to miss a season, but I also knew this was not in any sense an “undue hardship.” I could see that if the rule was not enforced in this case, I would be undermining its enforcement in other cases, and effectively changing the rule.
And I recognized that I did not have the authority to change a rule which the MHSAA Representative Council and each member school’s board of education had adopted to bring consistency and control to competitive athletics.
Many years have passed, and I’ve had to consider the eligibility of countless students to represent their schools on athletic teams. But I still see each situation as an individual student, balancing his or her individual needs and desires against the need to protect the integrity of the rules and the desire to promote competitive equity within the program.