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P E A K | W I N T E R 2 0 1 5 risk of false diagnoses, one of the reasons why EKG testing isn't universally embraced. Another reason: the incidence of abnormalities is so rare. "What we hope to do, and it will be very interesting to see five years from now when more data is in and it's really looked at, is determine whether this is cost effective," said Turco. "That's always a difficult thing to say when you're talking about a death, but ultimately it's whether it is cost effective to screen everybody with an EKG." Another benefit to Dartmouth doing the cardiac protocol is that it will afford the opportunity to study how the results sent in by the student-athlete's medical provider at home hold up against the results found locally. "Is there evidence that when you ask people to do it at home it doesn't get done as well?" asked Turco. "Or is it better to have a dedicated group doing them over and over again? It would be interesting to tease that out. "What you might find is something like 20 percent of people don't get pulses done in the groin on both sides, which is important." Conducting the on-site EKG and the entire cardiac protocol benefits not just the student-athletes who have been tested at Dick's House but those who will come after them, which is why Patterson, the cross country ski coach who lost an athlete last year, applauds the effort. "These things are being put in place and in Torin's case it may or may not have made a difference, " he said. "But it is going to make a difference, if it hasn't already. When trag- edies happen we can not only mourn, but learn from them." That's a key component of the Dartmouth protocol according to Beaver. "The NCAA and the American College of Cardiology three years ago created a sports and exercise council," he explained. "They are trying to get cardiologists of the future to understand the athlete better, which is important because the majority of our population from a cardiology standpoint is Medicare-age people. "We do have younger patients, but they have more traditional diseases, so understanding athletes and the screening test that you do on them is important. That's why having the Cardiology Fellows involved in this process is an important educational piece for them." Also important, according to Beaver, is the next step in making participation safer not only for the athletes, but for everyone around them. Basketball's Hank Gathers and Pete Maravich collapsed and died. The NHL's Rich Peverly, 15-year-old local basketball player Chris Roberge, and a parent a at a local high school basketball game last year survived incidents. "What did the ones who lived have in common?" Beaver asked. "They got defibrillated. There was a defibrillator on the sideline and people who knew how to use it. "The more people that understand the warning signs, whether it is faculty, trainers or other students, the better. Schools are now starting to enlist the other athletes in defibrillator training. You don't want the coach to be the only one who is trained because what happens if the coach isn't there? "These events, although horrible, have allowed us to revisit where we are and how to make things safer for everyone on our campus. The important thing is to do as much prevention as you can. We want to make our athletes as safe as we possibly can, and then if something happens, to be ready for it." 27 THE MORE PEOPLE THAT UNDERSTAND THE WARNING SIGNS, WHETHER IT IS FACULTY, TRAINERS, COACHES OR OTHER STUDENTS, THE BETTER

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