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.”
Fantasy Land
March 8, 2013
Advocating at the national level for unachievable ideals not only diminishes the importance of those achieving reasonable accomplishments at the grassroots level, it also threatens the future of organized sports for the masses; and few organizations in a position to know better are doing as much to create these unintended consequences as the National Athletic Trainers Association.
It is a NATA-driven “Youth Sports Safety Alliance” that has developed a six-page manifesto for youth sports, including NATA’s “Secondary School Student Athletes’ Bill of Rights” which is mostly beyond the means of youth sports sponsors, and has marched to Capitol Hill to urge the federal legislature’s action to pursue those goals, among which is the conveniently unstated objective of advancing job opportunities and security for athletic trainers themselves.
MHSAA surveys indicate that, conservatively, fewer than 20 percent of Michigan high schools and junior high/middle schools have a full-time certified athletic trainer on staff. In fact, only a minority of schools think such a full-time position is necessary, given other cheaper options available to them in the form of contracted services of medical groups and the volunteered services of many other medical professionals. An even smaller minority has the means to pay for a full-time certified athletic trainer, given all the cuts in state aid to schools; and many schools – urban, suburban, rural and remote – wonder where in their communities they would find a certified athletic trainer if such were mandated everywhere.
NATA’s earlier recommendations in the extreme for acclimatization of players at the start of the football season have already resulted in a state law in Maryland that football coaches there criticize for leading to a less safe sport now that they have less time to teach technique and prepare players for first-game contact. In theory, NATA’s notions are nice ideas; but in practice, they are less safe for the participants. And anything that is less safe for the participants not only endangers today’s players, it also jeopardizes the future of the game. Which, by the way, does nothing to enhance employment opportunities for trainers.