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.”

Raising Expectations for Managing Heat and Humidity

February 19, 2013

The MHSAA Representative Council is scheduled to vote on March 22, 2013, to approve a “Model Policy for Managing Heat and Humidity” that would appear in the 2013-14 MHSAA Handbook.

The policy, patterned after a mandatory policy of the Kentucky High School Athletic Association, requires that temperature and humidity readings be taken at the site of activities 30 minutes before the start of the practice or competition and again 60 minutes after the start of that activity.  The readings must be recorded in writing and kept in the files of school administration.  Inexpensive devices may be used that automatically calculate the “heat index.”

If the heat index is below 95 degrees, only normal precautions are required.  However, readings of 95 to 99 degrees and then 100 to 104 degrees require additional precautions; and all activity must be postponed or suspended if the heat index climbs above 104 degrees.

When the air temperature is below 80 degrees, there is no combination of heat and humidity that will result in need to curtail activity.

This is being proposed as a model policy for 2013-14.  The MHSAA will monitor school districts’ acceptance of this policy or adoption of similar policies before considering a mandate of this or similar policies.

The model policy will be mandatory for MHSAA tournaments.