Health Histories
September 4, 2012
Eighteen months ago we completed two new preparticipation physical examination forms: (1) a two-sided card delivered without charge to schools in whatever quantity they need; and (2) a four-page form that is downloadable at MHSAA.com.
Both are improved from the previous card in that they ask more about family and student health history which, more than any cursory exam, helps identify potential health risks before participation. Both were developed with the cooperation and consensus of a diverse panel of medical experts assembled by the Michigan Department of Community Health.
At schools’ requests, the MHSAA has distributed more copies of the two-sided card than there are students enrolled in MHSAA member schools; so we know the form has widespread use. But still, this particular form is not required, which allows schools with a special local resource to utilize something they like better, and this also allows families with special needs to use the documents that best meet their child’s circumstances.
The take-away on this topic is that today’s standard of care is a comprehensive physical with detailed family history prior to first participation in school sports and, thereafter, more cursory annual exams, except when the student has had an injury or illness that requires more review.
Cardiac Screening
October 31, 2014
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.”