Dear Parents:

Over the past several years ECG’s have been offered in conjunction with the city wide high school physicals. This will be continued this year with some changes in the process for reading the ECG’s. Previously, Pediatric Cardiologist, Dr Bruce Hardy has been on site to interpret all the ECG’s, however Dr. Hardy has retired and we would like to thank him for his years of service to the Butte community. Starting this year Pediatric Cardiologist, Dr. Andrew Lashus from St. Vincent’s Healthcare in Billings will be interpreting all of the ECG’s that are performed during the physicals. Dr. Lashus will not be on site but all the ECG’s will be sent to him for interpretation. Once he is done evaluating all the ECG’s each parent will be notified of the results by May 31, 2016. If a child is found to have an abnormal ECG the parents will be given options on how and where they can get a follow up appointment for their child.

Parents and schools have generally relied on well-child check-up exams and sports exams to determine that risk of sudden cardiac death for student athletes. Recent medical research shows that the combination of a thorough history, physical exam, and ECG is superior to a history and physical exam alone in determining the risk of sudden cardiac death.

An ECG does not substitute for a pre-participation exam or a regular well-child check, but instead supplements those exams. A thorough history and exam, plus an ECG, will not identify all children at risk for sudden death, but it does identify more than a pre- participation history and physical exam or a well-child exam alone. Also, while the inclusion of an ECG will increase the possibility of finding an athlete at risk for sudden death it does not guarantee that all medical conditions that can lead to sudden cardiac death will be identified. There are a number of conditions that cannot be predicted by an ECG plus a history and physical exam.

If an ECG is preformed and felt to be abnormal the student will not be permitted to participate in competitive athletics until further evaluation is performed by a health care provider selected by the student’s parent.

An ECG is not required by high schools for participation in competitive athletics. However, we are providing a way to have an ECG done on your child at the same time as the screening sports per-participation examination.

Current national recommendations state that if your child received and ECG since entering high school and everything was normal a second ECG is not necessary, however it is the parent who must make the final decision about whether an ECG will be preformed on their child.

An additional fee of $5.00 will be charged for an ECG, but if any family is reluctant to have and ECG done for financial reasons, the ECG will be done at no charge. A parent must be present at the screening and sign the students screening participation, physical, and fill out the ECG contact information sheet. If ECG abnormalities are found, we will arrange follow-up and further work- up that will be needed to clear the athlete for sports participation.

Please check one of the following:

_____ I consent to an ECG exam for my child. _____ I decline an ECG exam for my child.

By signing below, I certify that I have read and understand this consent:

______/______/2016 Parent or legal guardian/representative signature Date

______Parent or legal guardian/representative printed name Student athlete printed name