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.”

A Dedicated Downtime

November 7, 2014

Those who administer, coach or play school sports have become familiar with the phrase “downtime” to describe that period just before a season when coaches are not allowed to assemble players for activities that look too much like practice being conducted before the earliest practice of the season is allowed by rule.
In school sports, therefore, we often consider the downtime as a time to do less as teams – less than during the season, and even less than what is allowed teams during most of the offseason. If student-athletes are going to prepare for the upcoming season, they do so more as individuals than as organized teams during the brief preseason downtime.
In this we might look to the arts and literature for assistance; for it is in the downtime – the time away, on one’s own – that many artists, writers and other creative types have found their inspiration for excellence.
In Daily Rituals: How Artists Work, author Mason Currey describes the working habits of 160 creative thinkers. A common theme is the time these people demanded to be away from others to walk, sit and ponder. To wonder. To work through obstacles that seemed to be blocking their progress.
This is an imperfect analogy for student-athletes and school coaches, but it’s still instructive. In fact, a disconnected downtime – one without television, texting, tweeting and team drills, but with time and space to earnestly assess strengths and address weaknesses – might be central to an effective prescription for the upcoming season.