The other area of sports medicine that has received a lot of attention is screening for health conditions that might endanger the young athlete. In recent years there have been several highly publicized cases of athletes dropping dead during sports activities. In hindsight, some of these deaths would have been prevented if the medical management of a heart condition had taken precedence over the pressure to play. Most states require that public school athletes have some medical screening before athletic participation. Unfortunately, few states have adequate requirements for the content of the screening and/or for who is allowed to do the screening.

Thirty years ago we lost many student athletes to heat stroke every year, particularly in the South and Southwest. A concerted effort to educate coaches and trainers about prevention and treatment has made heat stroke among athletes an uncommon occurrence today. Today, most sudden deaths during athletic participation are cardiac deaths. Many of the athletes who die have warning signs or symptoms that could be detected on a proper screening exam. The American Heart Association publishes consensus guidelines for athletic screening. Every physician who does routine screening for athletic participation should follow these guidelines and the recommendations of the American Academy of Pediatrics. Doing the minimum required by the school is not acceptable medical practice. The physician should keep in mind that signing that school physical is saying that the child is healthy enough to participate in the athletic activities without endangering life or health. The national medical standards are what the physician will be judged by if the child is injured by inadequate screening.