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.”

Baloney

January 27, 2015

When I was in high school and college I worked a different job each summer, usually looking for hard labor that would help prepare my body for the next football season, and each time confirming that it would not be my choice for lifetime employment. One summer I worked at a lumber yard and paper mill complex along the banks of the Wisconsin River.
Every day I ate lunch with the men who had made this their life’s work; and I grew in ways both positive and negative as I listened to their conversations and tales. We all brought our own lunch pails.
One day, one of the more veteran employees opened his lunchbox and flew into a rage. “I can’t believe it,” he exclaimed. “Baloney again! I hate baloney.”
Trying to calm him down, another worker said, “If you hate baloney so much, just ask your wife to make you something else.”
To which the complainer replied, “That won’t work. I make my own lunches,” which resulted in an uproar of laughter from the rest of us.
I thought of this incident recently as I was preparing to meet with constituents about the rules they most love to hate: policies relating to coach and player contact out of season. Those are our most criticized rules.
But it occurs to me, if we don’t like the sandwich we’re eating – out-of-season coaching rules – we should remember: we made them ourselves, and we can change them. In fact, no one is in a better position to do so than we are. And no one has a greater duty to do so than we have, if we really are in need of a new recipe.