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.”
Controlled Fires
July 24, 2012
Forest fires have recently been scorching the United States with unusual reach and rage. Infernos in the Upper Peninsula of Michigan, as well as Arizona, Colorado, Idaho, Nevada, New Mexico, Oregon, South Dakota, Utah and Wyoming, have made news in our state.
Behind the headlines of the lightning-ignited 150-square-mile devastation near Fort Collins, Colorado is the analysis of forestry and conservation experts that it has been the absence of small fires that has helped to fuel the large fire. Turns out that Smokey the Bear’s campaign to prevent forest fires may be partly at fault.
In most of life, little problems here and there help to avoid larger problems later. The little fires consume the fuel that would feed a catastrophic conflagration exploding out of pent-up fears or frustrations or long-festering problems.
Even those who work in the “prevention business” – whether that’s the US Forest Service or a statewide athletic association – must tolerate a few fires. They can have positive, productive effects, one of which is to keep small problems from growing large and more destructive.