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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.”

Less Means More

June 4, 2013

About a decade ago a trend began that is nearly a tidal wave today.  An exceptionally drastic act a decade ago is now an expected rite of each spring and summer.  Beginning in April and extending to September, trained and experienced athletic directors leave their jobs, and no one really replaces them.

Casualties of burnout and buyouts – in either case caused by a reduction of discretionary resources for local schools – full-time athletic directors retire or resign or are reassigned.  Replaced by part-time personnel or a school district employee with more hyphens in the job title than digits in the take-home pay.

The natural first reaction of the MHSAA was to think about ways to simplify and reduce the responsibilities it asks athletic directors to handle.  To dumb-down the expectations, if you will.

But lately, we’ve realized that first reaction is the wrong response to the cutbacks at the local level.  The better response – the necessary response – is for the MHSAA to both demand more and do more, in each case, to assure schools are maintaining a program worthy of the label “educational athletics.”

Here’s just some of what’s been happening as the MHSAA attempts to plug the holes that school districts have been opening in interscholastic athletic programs as they reallocate their precious resources:

  • First-year athletic directors are required to attend an in-person orientation at the MHSAA.  For other athletic directors, the MHSAA conducts league-based programs each August and six regional Athletic Director In-Service programs in September and October.  For athletic department secretaries the MHSAA began a separate in-service program in 2012.
  • Beginning in 2012-13, the MHSAA has provided athletic department management software to member high schools free of charge, and two dozen face-to-face training sessions have been conducted.  The software is progressively integrating local tasks with MHSAA policies and procedures, both to reduce the workload and improve rules compliance at the local level.
  • While frequent coaches meetings and meaningful mentoring were once the expectation of athletic directors, their lack of time and experience has resulted in less effective supervision of coaches.  This led a decade ago to a retooling of the MHSAA’s coaching education program – the Coaches Advancement Program – which the MHSAA delivers anytime to school districts anywhere they can assemble their coaches.  Currently, the MHSAA is advancing three enhancements to the preparation of coaches in the critical area of participant health and safety.

o On May 5, 2013, the Representative Council adopted the requirement beginning in 2014-15 that all assistant and subvarsity coaches complete the same online rules meeting as varsity head coaches or, in the alternative, one of the free online health and safety courses posted on MHSAA.com.

o The next two enhancements to be considered are (1) the requirement that all varsity head coaches hold current CPR certification (as of 2015-16); and (2) that all varsity head coaches hired on or after July 1, 2016 have completed CAP Level 1 or 2.

  • The MHSAA’s adoption of a “Model Policy for Managing Heat & Humidity” is another example of pushing forward on critical issues of school sports and not assuming that under-resourced and understaffed school athletic departments will have the time to develop and adopt their own policies and procedures that are appropriate for school-based, student-centered sports.

As schools find they must do less, the MHSAA sees it must do more.  That wasn’t the design for school sports in Michigan, but now the times demand it.