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.”
The Trump Card
August 30, 2013
The cardinal principles for those preparing the playing rules of school sports are these:
- Preserve the sound traditions of the sport.
- Minimize risk.
- Provide for orderly administration.
- Maintain balance between offense and defense.
These were recited frequently when I was an employee of the National Federation of State High School Associations early in my career, when I was the staff liaison to the rules committees for ice hockey, soccer, swimming & diving and volleyball. These principles have been repeated many times over many years as the filter for proposals to modify contest rules in all sports.
A serious student of playing rules has known that the high school rules – enforced by part-time officials – generally have fewer exceptions than the rules on higher levels where officials have more time and training. NFL football, for example, will have exception upon exception to general principles of rules enforcement, which high school rules makers avoid. In other words, ease of administration has been more important for the high school level than a perfect balance between offense and defense in every circumstance of the contest.
It is clear now that the rules makers on all levels – from the pros to peewees – have concluded that “player safety trumps competitive advantage.” Exactly that phrase was used by some of the nation’s highest profile sports officials and supervisors of officials at high school, college and professional levels during a panel discussion closing the National Association of Sports Officials Summit in Grand Rapids last month.
More than perfect balance between offense and defense, more than ease of administration, even more than preserving the sound traditions of the sport, the rules makers are demanding player protection. In subtle ways in some sports, and smack between the eyes in football.
Go to the MHSAA Health & Safety Page, or the Football Page for more.