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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.”

Ready for Some Football

August 12, 2014

How seriously should we take public criticism of tackle football when that public promotes boxing or cage fighting? Or how seriously should we take public criticism of football played with helmets when that public allows motorcyclists to ride without any helmets at all?
This fickle if not hypocritical focus on football deserves to be exposed. 
However, and more importantly, this does not reduce our obligation to rise above the obvious questions of fair and balanced criticism and keep pressing for a safer environment for schools’ most popular participation sport.
In Michigan this has led to new limitations on head-to-head contact in football practices that began for more than 600 high schools this week. Specifically, no team or individual may participate in more than one collision practice per day before the first game, and no more than two collision practices per week after the first game.
The new policies promote instruction in proper blocking and tackling technique. It is full speed head-to-head contact that is further reduced, not full speed shoulder contact with sleds, shields and dummies nor slow speed contact between players.
Last month, and perhaps two years too late to be helpful, the National Federation of State High School Associations hosted a high-profile, high-powered summit to discuss practice policies of the kind that we developed, debated and adopted during the past school year to be ready for this 2014 season.