Medical Clearance for Student Athletes-Add an ECG and Echo!:Graehm Gray

Sep 20 2010

Medical Clearance for Student Athletes-Add an ECG and Echo!:Graehm Gray

I usually write about childhood obesity issues, nutrition or fitness but I want to make a slight departure and discuss an issue that I feel very passionate about: Medical clearance of student athletes. Maybe the timing of this article is due to news of several student athletes in various sports, from running to football, collapsing and dying on the field, either from seizures or heart problems. It’s not a new story. Children in school sponsored sports programs have been dying every year, all over this country. Sometimes it’s a headline in the “Local” section of your daily newspaper or on your local market television news show. Sometimes it makes it to the network morning shows as a segment. It’s even discussed and debated on a national level by heart specialists and sport medicine specialists. The American Heart Association has even gone on record by saying that the current clearance guidelines are inadequate. But what has been done?Nothing. There is no consensus on the proper way to screen a child that will enter a sports program.

Where are we now? Up to this point, most public and private schools require students that want to enter a sports program to have a medical exam or a Pre-participation Physical Examination.

According to the American College of Sports Medicine, the pre-participation physical exam (PPE) is an important step toward safe participation in organized sports.

The PPE has the following goals:

•Identify medical and orthopedic problems of sufficient severity to place the athlete at risk for injury or illness.

•Identify correctable problems that may impair the athlete’s ability to perform.

•Help maintain the health and safety of the athlete.

•Assess fitness level for specific sports.

•Educate athletes and parents concerning sports, exercise, injuries, and other health-related issues.

•Meet legal and insurance requirements.

Is this enough? I don’t think so. Despite these physical examinations, some students with medical problems (heart, brain, etc.) are slipping through the cracks. Why? What are we missing? Obviously we are missing vital information in these young victims with heart and brain disease, that may have led to the discovery that they should not have been out on the field or on the track competing. Yes, this could be a devastating finding for the young athlete; a finding that could potentially prevent them from participating in a sports program; a finding that could derail their chances of making a career from their sports choice; a finding that could prevent them from earning millions of dollars in sports contracts. But isn’t it worth it?

Is there enough information or data in the medical history and physical to make appropriate decisions? To make the best, safest and most accurate decisions for the child? I believe not. Should we limit the pre-participation exams only to basic and cursory history taking and physical examinations? No! Are questions enough? No! Shouldn’t we employ the standard technology available that we use every day to analyze and treat adult patients, on our children? The answer should be a resounding yes.

It is a proven fact that many medical problems, some serious, are silent (e.g. hypertrophic cardiomyopathy, congenital heart disease, hyperlipidemia), unknown to the athlete and can only be found with medical tests. In the field of cardiology, there are several tests that can be performed non invasively and within a matter of minutes. These tests can yield vital information that can save lives. What exactly are these tests: well first is an electrocardiogram (cardiogram or ECG) or as it is known on television – EKG. This inexpensive test, in five seconds, can show the electrical pattern of the heart rhythm. The second test is called an echocardiogram (echo, sonogram, or heart ultrasound). It can also be done quickly and inexpensively with sound waves and no radiation. The echocardiogram can show the structure of the heart muscle and the motion of blood through the heart.

Both of these tests can provide enormous amounts of information about a person’s heart and give the medical professional an edge in deciding the appropriate call to allow a child to exercise or not. It can mean the matter of life and a future or potential life threatening danger. These tests can reveal undiagnosed problems! These tests can save lives. These tests help save lives now! Why not use them for our children?

Oh yes, the cost and effectiveness of screening every child to find the small number of kids that have a potential heart ailment. It’s true, performing medical tests has an expense. And in these economic times, the idea of requesting more funds for a school system that is already over budget will not be popular. But isn’t the life saved worth this cost. Shouldn’t we be proud to say that my tax dollars are saving children’s lives instead of helping banks and insurance companies?

My friends, 30 million children participate in sports programs in the United States. Every year approximately 3.5 million of these kids suffer an accident, thankfully most are not lethal. Do we want to hear, “grief counselors are on hand to help” after the fact. Do we want to hear, “the autopsy of the child is pending” the day after. Our children are our most valuable and precious commodity. We place so much emphasis on them eating well, exercising, learning and growing. Shouldn’t we provide the means for a thorough physical examination for their safety before we give our permission for them to participate in a sport? And if we find, through our examination, that a child should not exercise due to an undiagnosed heart problem, and because of that information, he or she can grow up to become an adult, have a family, and be a vital part of society, isn’t that worth the cost? I believe it is.

Here’s what we can do:

Make it mandatory for every student athlete to undergo the Pre-participation Physical Examination by a qualified medical professional
Make it mandatory to perform a cardiogram (ECG) and cardiac ultrasound (ECHO) on EVERY student athlete
Make it mandatory for every athletic department to be equipped with Automatic External Defibrillator’s (AED) and all coaches and support personnel to be trained in CPR.

Stay fit and healthy The New Nerdel Way.

Links and sources used for this article: please check them out: