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.”

Driving Lessons

August 19, 2014

Many millions of us this summer took to the expressways of North America, and most of us reached our destinations safely. I find myself amazed at how few the accidents are when highways are crowded with hunks of metal traveling at 60, 70 and even 80 miles per hour.

There are three actions on a fast-moving expressway that jeopardize the health of travelers that are like three actions that jeopardize the health of organizations.

  • First, if any number of drivers defies heavy traffic or wet pavement, then the well-being of all the others is at risk.

  • Second, if just a single car ahead of a crowd of others slams on the brakes, then a chain reaction collision is likely to follow.

  • Third, if a driver fails to look around and indicate the intention to change lanes, then those around that car must take evasive actions to escape trouble.

Likewise, organization leaders who move forward too fast without regard to their environment, leaders who suddenly slow down or stop their forward motion, and leaders who fail to consult with those around them and clearly signal their intentions to make a change, put their enterprise at risk.

Lessons for the office, learned on the road.