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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.”

More Than X’s & O’s

April 17, 2015

It’s nearly the fourth quarter. We are just completing year six of eight years in which we have been addressing four important health and safety issues that, for ease of conversation, we call the “Four H’s.” These are much more important than the X’s and O’s of sports.
During the 2009-10 and 2010-11 school years, the first quarter, our focus was on Health Histories. During this time we made enhancements in the pre-participation physical examination form, stressing the student’s health history, which we believe was and is the essential first step to participant health and safety.
During the 2011-12 and 2012-13 school years, the second quarter, our focus was on Heads. We were an early adopter – before state law mandates – of removal-from-play and return-to-play protocols, and our preseason rules/risk management meetings for coaches included information on concussion prevention, recognition and aftercare.
Without leaving that behind, during the 2013-14 and 2014-15 school years, the third quarter, our focus was on Heat – acclimatization. We adopted a policy to manage heat and humidity – it is recommended for regular season and it’s a requirement for MHSAA tournaments. The rules/risk management meetings for coaches during these years focused on heat and humidity management. At the mid-point of this two-year period, the MHSAA adopted policies to enhance acclimatization at early season football practices and to reduce head contact at practices all season long.
Without leaving any of the three previous health and safety “H’s” behind, during the 2015-16 and 2016-17 school years, the fourth quarter, our focus will be on Hearts – sudden cardiac arrest and sudden cardiac death. Coinciding with this emphasis is the requirement that all high school level, varsity level head coaches be CPR certified starting this fall. Our emphasis will be on AEDs and emergency action plans – having them and rehearsing them; and this summer we are expecting to deliver to every high school free of charge the “Anyone Can Save a Life” program developed in Minnesota and being distributed nationwide with the assistance of the National Federation of State High School Associations.