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.”

Many Big Changes Ahead

April 25, 2014

The May meeting of the MHSAA Representative Council is usually the one that produces the most action leading to the most change in Michigan school sports. This year, however, the Council could skip this meeting entirely, and still school sports would be in for the greatest number of significant positive changes that we have ever seen over any previous two- to three-year period.

In the area of health and safety, schools will be in the second year of the “Model Policy for Managing Heat & Humidity” adopted in March of 2013 and the first year of new Football Practice Policies adopted in March of 2014. The practice policies lengthen the early season acclimatization period from three days to four and reduce collision practices to one per day prior to the first game and to two per week thereafter.

This fall, the first of three enhancements to the health and safety preparation of coaches takes effect. All high school assistant and subvarsity coaches must complete a rules and risk management requirement similar to high school varsity head coaches. In the fall of 2015, all high school varsity head coaches must be CPR certified. In the fall of 2016, all first-time high school varsity head coaches must have completed the MHSAA’s Coaches Advancement Program Level 1 or 2.

This fall brings two big changes in the transfer regulation. The athletic-related transfer rule adopted in 2013 takes full effect Aug. 1, 2014, as do rules that remove different treatment of J-1 and F-1 visa students and the disparate impact of Federal laws on public and nonpublic schools with respect to F-1 students.

Meanwhile, the MHSAA has already committed all of 2014 to a comprehensive examination of some very large junior high/middle school issues (e.g., should we be including younger grades and should there be Regional tournaments); while during the second half of 2014, there will be new looks at out-of-season coaching rules and broader application of “subvarsity” level opportunities to transfer and international students.

Even if the Representative Council makes no changes at its May 4 and 5 meetings, the fall of 2014 will be the busiest I’ve been a part of in 29 years.