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Doctors Not Following Sudden Cardiac Death Screening Guidelines for Athletes | Daytona Beach Malpractice Attorney

Doctors Not Following Sudden Cardiac Death Screening Guidelines for Athletes

Less than 6 percent of doctors follow national guidelines for assessing sudden cardiac death risk during high school sports physicals, according to a new state survey.

Fewer than half of the doctors and only 6 percent of the athletic directors reported they were even aware of the guidelines. And none of the athletic directors said their schools required physicals to comply with these guidelines.

The study was based on responses received from 1,113 family doctors and pediatricians and 317 high school athletic directors in Washington state.

Sudden cardiac arrest occurs when the heart suddenly and unexpectedly stops beating due to an irregular heart rhythm. Death occurs within minutes without treatment. Among more than 7 million U.S. high school athletes, one out of every 30,000 to 50,000 dies each year from out-of-hospital sudden cardiac arrest.

“A young person at the peak of physical prowess, dying without any warning — it’s a shocking, tragic and potentially preventable death,” said lead study author Dr. Nicolas Madsen, pediatric cardiology fellow at Seattle Children’s Hospital and the University of Washington School of Medicine.

The American Heart Association published a 12-point screening guidelines for sudden cardiac death for athletes in 1996 and re-affirmed them in 2007. They consist of eight questions about medical history and four physical exam elements, including checking blood pressure and listening to the heart.

Researchers sent 2,190 surveys by mail and email to pediatricians, family doctors and athletic directors over the course of two months. The uncommonly high response rate — 56 to 75 percent — suggests a compelling interest in the issue, researchers say.
While doctors were questioned about pre-sports physicals, athletic directors were asked about their school’s requirements for physicals.

Regression analysis and other techniques were then used by researchers to determine the level of compliance with national guidelines.

Physicians reported missing several critical questions during screenings:

  • 28 percent did not always ask about chest pain during exercise;
  • 26 percent didn’t always ask about a history of early death in the family;
  • 22 percent didn’t always ask about unexplained fainting;
  • 67 percent didn’t always ask about family history of heart disease.

The study’s results didn’t change with the doctor’s specialty, level of experience, location or the athletes’ school size. Greater compliance was linked to screening frequency and familiarity with the guidelines.

Madsen said new directions are needed to improve policy requirements and educate providers so students and their families can benefit from these national guidelines.

The doctors and athletic directors unanimously supported the adoption of a statewide form that would incorporate these national screening guidelines. Madsen said parents should ask their doctors and schools if they are using a standardized form.

For more on medical safety issues, see the library of articles by Daytona Beach medical malpractice attorney.


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