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.”

Ice Hockey Penalties

May 27, 2014

After each rules committee of the National Federation of State High School Associations meets, the list of changes is sent to all member state high school associations for advance examination before being finalized and publicized.

Recently, I took special notice of the work of the NFHS Ice Hockey Rules Committee. What caught my attention first was the brevity of its list of rules changes for 2014-15 – just three items. And then I was struck at the stated purpose of each of the three changes: risk minimization.

  • The penalty for a check, cross-check, elbow, charge or trip that causes the opponent to be thrown violently into the boards is no longer a Major or Minor – it’s a Major (five minutes).
  • If a check is flagrant or causes the opponent to crash head-first into the boards, a Major and Misconduct or Game Disqualification penalty must be assessed.
  • The penalty for a push, charge, cross-check or body-check from behind in open ice is no longer a Minor and Misconduct – it’s a Major.

Only three rule changes .. three tougher penalties.

Committee chair Tom Shafranski of Wisconsin commented after the meeting: “In each case, the rule has been strengthened for officials to assess a stronger penalty than in the past – a good strategy for further protection of high school hockey players ... There will likely be traditionalists who don’t agree with the increase in penalty time; however, boarding and checking from behind (even in open ice) are high school hockey’s most dangerous contact situations.”

MHSAA Assistant Director Cody Inglis serves on the NFHS Ice Hockey Rules Committee and supported these changes.