Sport Safety

Health and Safety Policy Ranking for High School Athletics

Samantha Scarneo, MS, ATC

Director of Sport Safety

On Tuesday, August 8th, the Korey Stringer Institute held a press conference for the release of the Health and Safety Policy Ranking for High School Athletics. The goal of this project was to review publically available information from high school associations and state legislation to determine how states are mandating safety standards for their athletes. A positive finding from this study is every state, including the District of Columbia, has some type of health and safety policy requirement for their high schools to follow. However, not a single state meets all of the minimum best practice requirements for the areas focused on in this project; which happen to be the top causes of sudden death in sport, accounting for over 90% of sport-related deaths.

 

North Carolina is leading the way scoring a 79%, followed by Kentucky (71.13%) and Massachusetts (67.4%). KSI was honored to have Mr. Bob Gfeller, Mr. David Csillan, and Dr. Morgan Anderson as well as Dr. Douglas Casa and Dr. William Adams, speak at the press conference. Dr. Adams began the press conference stating the methods used for this project, which included accessing publically available information from state high school associations and legislation. Dr. Casa followed up with information pertaining to the results of the study. Csillan, athletic trainer from New Jersey, provided comments about his continued advocacy for New Jersey to implement best practice standards statewide. Mr. Gfeller spoke on the importance of implementing policies to ensure that no parents need to go through the tragic loss of a child. Dr. Morgan Anderson echoed these comments by stating “We have tragic examples from the past that motivates us daily to make a change.”

The Orthopedic Journal of Sports Medicine will publish the study with these findings in the September issue. The accepted version of the PDF can be found here.

Change is difficult. There may be states who are not thrilled with these published findings, too. However, these data are the reality of current health and safety policies in high school athletics. This report is dedicated to the parents who have lost, or those parents who have their sons and daughters participating in sport, and it can be the conduit in making sure that your children’s safety are accounted for by the governing organizations. I urge you all to contact your state high school association leaders and legislators to find out if they are 1) aware of where they stand in the ranking and 2) their plans forward for improvement.

NATA Clinical Symposia & Expo

Alexandra Finn

Assistant Director of Education

Athletic trainers from around the country gathered in Houston, Texas for the 2017 Annual NATA Clinical Symposia & AT Expo. The four day Clinical Symposia provided athletic trainers with the ability to explore new areas and benefit from the latest research. KSI was well represented by fifteen presenters who continued the mission of educating athletic trainers about our latest research. The warm weather of Texas was a constant reminder of the significance of heat in our southern states, but the strong interest showed by attendees from across the country demonstrated that athletic trainers are gaining an understanding that exertional heat illnesses are an issue of national concern. The selection of so many KSI members provided a unique opportunity for KSI to further its educational mission to maximize performance, optimize safety and prevent sudden death in sport.

Presentations kicked off early Tuesday morning when Andres Almeraya presented in the Master’s Oral Student Finalist session. His research about “Implementation of Automated Defibrillator Policies in Secondary School Athletics” demonstrated the strong need for additional state legislation to mandate that all secondary schools follow best practices. Andres entered the day as a finalist and was selected overall the best oral presentation in this section. Congratulations and well done, Andres! Dr. William Adams presented his work on the “Implementation of Heat Acclimatization Policies in Secondary School Athletics” during the Treat the Heat Session.

This year four KSI staff members: Luke Belval, Alexandra Finn, Rachel Katch and Brad Endres were selected to present a Free Communication Poster Presentation on Tuesday morning. Luke Belval presented on “Sex-based Comparison of Exertional Heat Stroke Incidence in a Warm-Weather Road Race.” Alexandra Finn presented on the “Implementation of Wet Bulb Globe Temperature Policies in Secondary School Athletics.” This research revealed that currently there are only three states that meet all the best practice recommendations in this area. Rachel Katch presented data titled “Cold Water Immersion in the Treatment of Exertional Heat Stroke Remains the Gold Standard at the Falmouth Road Race,” which demonstrated the significance of a road race having immediate cold water immersion available to treat exertional heat stroke. Finally, Brad Endres presented on the “Epidemiology of Sudden Cardiac Death in American Youth Sports.” Congratulations to both Alexandra Finn and Brad Endres who were selected as Master’s Poster Presentation Finalists. Brad’s poster proved to be the judges’ favorite taking home top honors for KSI in this category. Well done Brad and his research team!

Dr. Rebecca Stearns presented research during the session “When Exercise Gets Hot.” Her study focused on “Repeated Exertional Heat Stroke Incidence in a Warm-Weather Road Race.” Following Dr. Stearns presentation, two KSI members; Kelly Coleman and Alicia Pike spoke during the Diversity and Inclusion Considerations in Athletic Training session. Kelly Coleman presented data about the “Perceptions of Race and Ethnic Diversity on Athletic Training Clinical Practice” while Alicia Pike spoke about “Providing Medical Care to Male Sports Teams: Attractors to Employment for Female Athletic Trainers.

To finish the day, Dr. Robert Huggins provided an update on “An Overview of Secondary Schools ATLAS Project: Where Are We Now?” demonstrating the progress in mapping secondary schools across the nation.

The second day started off strong with three KSI members presenting. First, Sarah Attanasio provided insightful information about the ATLAS project. In a well-attended session, Dr. Douglas Casa discussed “Catastrophic Heat and Exertional-Related Condition Among Athletes.” Lastly, Samantha Scarneo presented data about “Implementation of Emergency Action Plan Policies in Secondary School Athletics.” Her study focused on the importance of every high school having an athletic trainer prepare an emergency care plan.

On the final day of presentations KSI members Kelsey Rynkiewicz, Dr. Robert Huggins, Dr. Yuri Hosokawa, Dr. William Adams and Alicia Pike all had an opportunity to present their data. Kelsey Rynkiewicz presented data on the “Implementation of Concussion Policies in Secondary School Athletics.” Dr. Robert Huggins presented on three different topics on Thursday. The first presentation looked at the “Presence of Athletic Trainers, Emergency Action Plans, and Emergency Training at the Time of Sudden Death in Secondary Athletics.” His second presentation provided data to support why all athletic trainers should be staffed and the importance of an athletic trainer in the ability to reduce risk and save lives. His last presentation was titled “State High School Athletic Policy Change Successes and Barriers: Results from Collaborative Solutions for Safety in Sports Meeting.” Dr. Yuri Hosokawa presented information on “Optimizing the Direction of Care: A Secondary Insurance Claim Analysis.” Dr. William Adams presented information on the “Current Status of Evidence-Based Best Practice Recommendations in Secondary School Athletics.”  Lastly, Alicia Pike looked at “Examining Sport Safety Policies in Secondary Schools: An Analysis of States’ Progress Toward and Barriers to Policy Implementation.”

It was a privilege for so many KSI members to have the opportunity to provide much needed information about subject matters such as the prevention and care of exertional heat illnesses to athletic trainers who are heading to summer sport training camps or planning for preseason training for fall sports. When not presenting, KSI staff members took advantage of the tremendous opportunity to learn from colleagues from other institutions. The annual conference, which will be moving to New Orleans, LA next year, is well worth the investment to attend!

2017 Youth Sport Safety Governing Bodies Meeting

Samantha Scarneo, MS, ATC, Director of Sport Safety

Screen Shot 2017-02-26 at 6.48.14 PMFour years ago, Dr. Casa had a vision to bring together the representatives responsible for safety initiatives for the leading national governing bodies (NGBs) of youth sports and educate them on how to make their sport safer. This past week, the four-year effort concluded with a meeting at the National Athletic Trainers Association (NATA) headquarters in Carrollton, TX. We have accomplished an astonishing amount over the past three years. In 2015, the 1st Youth Sport Safety Governing Bodies (YSSGB) Meeting was convened by the Korey Stringer Institute and hosted by the National Football League in New York, NY. The goal of this inaugural meeting was to educate the NGB attendees on the top causes of sudden death in sport and to learn what various NGBs have done up to this point to improve youth athlete safety. From this meeting, we were able to leave with a better understanding of the inner-workings of the NGBs; we also learned that it was extremely difficult for NGBs to provide any type of mandate or requirement because they do not have a structure to govern and oversee mandates outside of sport rules. From there, we knew we needed to create a document that outlines what the best practice recommendations should be for youth organizations.

Several position statements, consensus statements, inter-association task force documents, and research articles have been published by professional organizations. However, these documents have had a focus on the high school and older athlete, leaving paucity in the literature as to best practice recommendations for the youth athlete. The 2nd YSSGB meeting led by the Korey Stringer Institute and the National Athletic Trainers’ Association in 2016 focused on creation of a document and aimed to get feedback from the NGBs on what should be included in a best practice document. The outcome from this meeting includes a document to serve as the first of its kind to guide recommendations for improving sport safety for the youth athlete.

 

It was also in the 2016 meeting that the leaders in the NGBs requested to KSI and NATA that we convene to discuss how to continue efforts to make youth sport safer. Which led to our objective for the 2017 YSSGB meeting to discuss the potential tasks that should be addressed for future efforts and again lead by the NATA and KSI.

 

This year’s attendees included a mix of both new faces and veterans to the meeting:

 

US All Star Federation USA Lacrosse
USA Baseball US Soccer
USA Basketball USA Football
USA Track and Field USA Wrestling
USA Gymnastics USA Hockey
American Academy of Pediatrics American Medical Society for Sports Medicine
Korey Stringer Institute National Athletic Trainers Association
Safe Kids World Wide

 

At the meeting, we discussed strengths, areas for improvement, facilitators and barriers for promoting safety initiatives within their own organizations. We had veteran NGBs that discussed their successes and struggles in spearheading the youth sport safety initiatives, while other NGBs that are relatively new shared their recent achievement in mandating the background checks for their coaches, which is also an important topic to be addressed by the NGBs to ensure youth athlete safety. Every representative from the NGBs believed that they could continue to learn from this collaborative effort and were  hopeful for future meetings to continue their discussions in keeping their youth athletes safe.

 

I would be remiss if I did not conclude with a heart-felt thank you to the NATA for their extremely warm welcome to their facilities and for their sponsorship of the meeting. Specifically, to Katie Scott, MS, ATC, Athletic Trainer in Residence at the NATA, for all of her time and effort into the creation of this meeting during the past two years, and for her continued commitment, dedication, and passion for improving the profession of athletic training and sport safety for all athletes. I would also like to thank the NATA Foundation for hosting our dinner on Thursday night, and to Camelback and Jones and Bartlett for donating their products.

 

As I have concluded this blog post the past two years, If you want to go fast, go alone. If you want to go far, go together”—Unknown.

The Rise of the Quantified Athlete Review

Courteney Benjamin, MS, CSCS, Associate Director of Communication and Assistant Director of Athlete Performance and Safety

Gabrielle Giersch, MS, Associate Director of Education and Assistant Director of Athlete Performance and Safety

 

It’s not a secret that the use of wearable technology in sports is a hot topic among many of the world’s leading experts in sports and research. The popularity of this idea led to the creation of the first symposium of its kind called “The Rise of the Quantified Athlete.” Harvard Innovation Labs, Sports Innovation Lab, and OneTeam Collective worked together to create what is sure to be the first of many similar meetings between the world’s leading experts and innovators in sports and technology. At this symposium, there were four panels designed for informing, optimizing, and focusing the use of wearable technologies in sports and a fifth panel of elite athletes centering on their experiences with various technologies.

We were fortunate to attend this meeting at the world-class facilities of the Harvard Innovation Lab on Harvard University’s campus in Boston, MA. This lab “is a unique collaboration and education space designed to foster entrepreneurship and innovation across Harvard.1

Screen Shot 2017-02-23 at 7.57.02 PM

This group worked with the Sports Innovation Lab founders Isaiah Kacyvenski (NFL veteran), Angela Ruggiero (Hockey Olympic Gold Medalist), and Joshua Walker (Researcher) to put on this event.  The purpose of this organization is to “identify and evaluate the technology products and services that will power the future of sports.2” OneTeam Collective, the third partner responsible for putting on this event, is an organization “designed to accelerate growth for companies seeking to align with the sports industry.3

The organizations that attended this meeting ranged from veterans to up-and-coming companies trying to gain a niche in this growing market. In addition to our group from KSI, the following companies and/or organizations were involved in the panel discussions.

Company/Organization Website
Harvard Innovation Lab https://i-lab.harvard.edu/
Sports Innovation Lab https://www.sportsilab.com/
OneTeam Collective http://www.oneteamcollective.com/
Intel http://www.intel.com/content/www/us/en/wearables/wearables-overview.html
Gatorade Sports Science Institute http://www.gssiweb.org/en
ESPN Sports Science http://www.espn.com/espn/sportscience/
US Army http://www.usariem.army.mil/
Harvard Biodesign Lab http://biodesign.seas.harvard.edu/
MIT Sports Technology Group https://innovation.mit.edu/
USC Center for Body and Computing https://www.uscbodycomputing.org/
VERT https://www.myvert.com/
NIX http://nixbiosensors.com/
MC10 https://www.mc10inc.com/
Humon https://humon.io/
Halo Neuroscience https://www.haloneuro.com/
Rabil Companies http://endurancecos.com/meet-the-team/paul-rabil/
STRIVR Labs http://strivrlabs.com/
WHOOP http://whoop.com/
Zebra Technologies https://www.zebra.com/us/en/solutions/location-solutions/zebra-sport-solution.html
STATS https://www.stats.com/

 

 

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Dr. Casa during the “4th Quarter” Panel Discussion

Dr. Douglas Casa served on the third panel titled: “Software Changing the Role of Coaches and the Analysis of Athletic Performance” where he was able to discuss the importance of research in development of wearable technologies and how KSI has been involved in that research world. He suggested that every company entering this market should reach out to a third-party research group to validate their device in a peer-reviewed fashion. This type of validation will provide the company and the consumer confidence that their product works.

 

To wrap up the symposium, the following big names in sports discussed their experience with technology:

Matt Hasselbeck IMG_0393(NFL, ESPN), Ryan Fitzpatrick (NY Jets), Sean Sansiveri (NFLPA), Dr. Leslie Saxon (USC Center for Body Computing), Meghan Duggan (United States Olympic Committee), Paul Rabil (MLL and US Lacrosse), Zak DeOssie (NY Giants), Shawn Springs (NFL), andCraig Adams (NHL).

 

Overall, this symposium was an awesome start to a much larger, much needed conversation. It seemed that the general consensus with most attendees was that all of the technology and data we are now able to gather is phenomenal. Moving forward, we must all continue to strive to validate every measurement tool, make sense of all of the data these tools are collecting, and determine best practices for using this analysis to make meaningful differences in performance. This is an exciting time to be in this field, in its infancy, when the potential for growth is limitless.

 

 

  1. Harvard i-lab. (n.d.). Retrieved February 23, 2017, from https://i-lab.harvard.edu/
  2. Sports Innovation Lab (n.d.). Retrieved February 23, 2017, from https://www.sportsilab.com/
  3. OneTeam Collective. Retrieved February 23, 2017, from https://www.nflpa.com/oneteamcollective

 

Pre-College Summer @ UConn

Pre College Summer

By Rachel Katch, MS, ATC, Associate Director of Military and Occupational Safety

The Korey Stringer Institute at the University of Connecticut is conducting its first Emergency Issues in Sports Medicine Pre-College Summer academic focus. In total there will be four, 1-week (17.5 hour) long seminars targeted towards future leaders in the high school setting, which features a curriculum of evidence-based prevention, recognition, and treatment of the Nation’s leading emergency issues in sports, military, and occupational settings. Each session includes interactive presentations disseminated by the experienced staff of the Korey Stringer Institute, as well as a hands on learning lab simulating the emergency treatment of a life threatening aliment. A broad range of emergent topics will be covered during the sessions including:

 

  • Cardiovascular events
  • Exertional heat illnesses
  • Concussions
  • Traumatic injuries
  • And other significant contributors to sudden death

 

Despite recent and proposed rule and policy changes at all levels of activity (i.e., NFL, USA Youth Soccer, NCAA, etc.), including the now punishable act of head-to-head contact during tackling in football and the removal of heading in youth soccer, sudden death due to the above conditions can still be an inherent aspect of sport and physical activity. Participants can expect to learn imperative knowledge in the understanding of today’s leading causes of death in sport and physical activity, including essential firsthand skills in the prevention, recognition, and treatment of these emergent injuries and illnesses.

 

With our first Sports Medicine session in the books, our curriculum has been very well received by students and has been regarded as interactive, engaging, rigorous, and very informative. Students have come away from this course with a new understanding of sports medicine and the number one causes of sudden death in sport and physical activity. When asked what was the most interesting/important thing they learned in our seminar, all responded with a resounding, “Everything!” Unfortunately, registration has closed for our 2016 seminars; however, keep a look out next year for our 2017 Pre-College Summer Sports Medicine Seminars!

 

If you have questions regarding the Emergency Issues in Sports Medicine Pre-College Summer academic focus, or the activities of the Korey Stringer Institute, please contact Rachel Katch at rachel.katch@uconn.edu

The ATLAS Project: The Start of Something Big

By Robert Huggins, PhD, ATC, VP of Research, VP of Athlete Health and Safety

ATLAS UPDATE

There are countless new and innovative ideas that we have at KSI every day, but every once in a while there is that truly life changing idea. Even as daunting as that idea may seem, there is something deep within your gut, I mean really deep down, that you know can make and impact and is worth doing. The ATLAS Project was one of those ideas for us here at KSI and in true KSI fashion this idea would not be possible without the collaboration of the NATA Secondary School Committee and the members of the NATA.

 

The Athletic Training Locations And Services Project was developed by KSI from the “Athletic Training Services in Public Secondary Schools: A Benchmark Study” with the main goals to:

 

  • Create a real-time database of athletic training services in secondary schools
  • Create a directory for each state’s athletic training association and high school athletics association
  • Assist states in moving toward full-time athletic training services
  • Provide useful data to each state’s athletic training association and high school athletic association
  • Identify common factors associated with increased athletic training services across the country
  • Provide data to assist with legislative efforts to improve healthcare for high school athletes

Since its official launch in January, over 4,500 surveys have been taken by Secondary School Athletic Trainers all across the country. The Eastern Athletic Trainers’ Association has the largest percentage of high school athletic trainers who have taken the ATLAS Survey closely followed by Mid-America Mid-Atlantic and Southwest Athletic Training Associations as depicted below. In terms of raw number of surveys California leads with 220 surveys taken and Pennsylvania is in close second with 203 surveys. However, if we look at percentage of surveys taken, District of Columbia, New Mexico, and Utah are in the lead with 80%, 71%, and 55% respectively.

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Currently KSI uses Zeemapsä by Zeesource to map each states’ Athletic Training services and we are proud to say that Vermont and Maine were the first two states to be 100% mapped. Delaware, District of Columbia, Rhode Island and Wyoming are all within 40 schools of being 100% mapped and additional efforts in those states by KSI and their athletic training associations are being made as we speak.
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Recently Robert Huggins PhD, LAT, ATC and Larry Cooper, NATA Secondary School Committee Chair, presented the ATLAS project data at the Collaborative Solutions For Safety In Sport Meeting held at the NCAA headquarters in Indianapolis and will also be discussing this with Athletic Trainers at the NATA Symposium next week in Baltimore where they hope the project will continue to gain more momentum so be sure to stop by booth #2057 at the NATA Expo to map your high school!

Texas House Advances Bill Mandating EKGs for High School Athletes (Education Week)

The Texas House of Representatives approved a bill last week that would require high school athletes to undergo an electrocardiogram, or an EKG, before participating on a sports team.

The bill, which passed the House on an 82-62 vote on April 14, would require all high school student-athletes at University Interscholastic League schools to have an EKG before the student’s first year of participation in sports, and again before his or her third year. If a parent or guardian submits a written request to waive the requirement, however, a student-athlete would not be required to undergo the EKG.

According to a 2011 study published in the journal Circulation, sudden cardiac arrest was the leading cause of death during exercise in NCAA student-athletes, and similar data has held true for younger athletes, too. State Rep. Sylvester Turner, one of the bill’s joint authors, believes mandating EKGs could help prevent some instances of sudden cardiac arrest by uncovering undiagnosed conditions.

“These deaths are preventable and we have the resources to inform Texas parents if their child is at risk,” said Turner in a statement. “The legislation does not require parents to take any medical action in response to an ECG. Regardless of the information the ECG provides, any medical decisions regarding the student athlete remain at the parent’s discretion.”

The legislation was inspired in part by Scott Stephens, who lost his son Cody to sudden cardiac arrest in May 2012. Since that time, Stephens started the Cody Stephens Go Big or Go Home Memorial Foundation, which helped screen over 15,000 athletes last year, according to The Dallas Morning News. Fifteen of those youth-athletes wound up needing heart surgery, and two were told to quit contact sports, the paper reported.

“We found 17 kids out of 15,000,” Stephens told the paper. “If there’s a million kids in the state of Texas getting a physical, that tells me—just by the math—that there’s 1,000 kids out there that are possible candidates for sudden cardiac arrest.”

If signed into law, the Texas bill would go into effect beginning with the 2016-17 school year. It has since been sent to the Senate for further discussion.

Sudden cardiac arrest has been a hot topic in youth-athlete safety for years. In 2011, a 16-year-old Michigan high school basketball player named Wes Leonard collapsed on the court after hitting a buzzer-beating shot due to an enlarged heart. After being rushed to the hospital and undergoing CPR, he was pronounced dead due to sudden cardiac arrest. His friends and family later createdThe Wes Leonard Heart Team to advocate for student-athlete-safety legislation, including a requirement that all public and private schools have enough automatic electronic defibrillators on site.

That same year, the National Athletic Trainers’ Association released a statement urging states to pass pending youth-athlete-safety legislation, despite any potential budgetary concerns. At its third annual Youth Sports Safety Summit in December 2011, association members discussed ways to prevent sudden death in youth sports.

“We believe that 90 to 95 percent of the deaths that happen in youth sports are preventable,” said Dr. Douglas Casa, the chief operating officer of the Korey Stringer Institute at the University of Connecticut, during that year’s summit.

In November 2011, a survey presented at the American Heart Association’s scientific sessions revealed that fewer than 6 percent of doctors in the state followed national sudden-cardiac-death screening guidelines to their fullest extent when examining high school athletes. Not a single athletic director said that his or her school required doctors to comply with all state guidelines at the time, either.

In the spring of 2012, meanwhile, then-Pa. Gov. Tom Corbett signed a law designed to protect student-athletes from heart failure. It required schools to issue an information sheet to parents of student-athletes about the warning signs and symptoms of sudden cardiac arrest, which they needed to sign and return to the school before their children were allowed to participate in athletics.

This past March, Dr. Brian Hainline, the NCAA’s first chief medical officer, divulged to The Wall Street Journal his plan to recommend “that athletes at higher risk of cardiac death, including male basketball players, be required to undergo an EKG test to search for cardiac defects,” according to the paper. However, “some 100 university team physicians” signed a petition “calling on him to change his mind,” the WSJ reported one month later, which he wound up doing.

“I have become convinced that the infrastructure and knowledge base will not support this effort at present,” Hainline announced at a conference in mid-April, per the paper.

The issue clearly remains contentious among medical experts, and the Texas House had its fair share of members opposed to the bill, too. We’ll see over the coming weeks whether Texas state senators express the same concerns.

 

Source: Education Week

Medical Experts Look Beyond Law to Make Youth Sports Safer (ABC News/AP)

To toughen safety standards in youth sports, medical experts are turning away from lawmakers and toward high school sports associations to implement policies and procedures to prevent deaths and serious injuries.

The National Athletic Trainers’ Association and the American Medical Society for Sports Medicine completed two days of meetings and programs with representatives from all 50 state high school athletic associations Friday at the NFL offices in Manhattan. The goal was to have decision-makers return to their states and push high schools to put into place recommendations on how best to handle potentially catastrophic medical conditions such as heat stroke, sudden cardiac arrest and head and neck injuries.

Some states, such as Arkansas, have passed laws requiring schools to meet certain standards, but Doug Casa, director of athletic training education at the University of Connecticut, said high school associations should be first to act because they have more flexibility to move quickly.

“Trying to get a state law passed, one, can take a long time but two, sometimes a lot of things get attached to the laws that weren’t the original intention. Also, they’re written by people who don’t truly understand the nuances of a football practice or how sports work into the system of a school year. Those are nuances that the state high school association totally gets,” Casa said.

In 2013, best practice recommendations were published in the Journal of Athletic Training, but many states are still lagging in implementation of those guidelines. They include having a full-time athletic trainer on staff, having automated external defibrillators in every school and accessible to all staff members, and having an emergency action plan for managing serious and potentially life threatening injuries. Funding is often cited as the reason schools, many of which are already struggling to make ends, meet fail to implement these recommendations.

According to the NATA and AMSSM, only 37 percent of high schools in the United States have full-time athletic trainers. Only 22 percent of states meet the recommendation that every school or organization that sponsors athletics develop an emergency action plan. Only 50 percent of states have met recommendations that all athletic trainers, coaches, administrators, school nurses and other staffers have access to an automated external defibrillator.

Casa said just 14 states meet the minimum best practices with regard to heat acclimatization, but the ones that have adopted them since 2011 have had no athlete deaths from heat stroke.

Casa cited Georgia, Arkansas, Texas, North Carolina and New Jersey as states that have been leaders in implementing the recommendations.

Jason Cates, a member of the executive committee of the Arkansas Athletic Trainers’ Association who led reforms in Arkansas after a high school basketball player died of sudden cardiac arrest in 2008, said that while legislation can be help to move programs forward, it can also create problems with legal liability.

“At what point in time are we going to legislate ourselves out of sports?” he said. “I think in some states, in some instances (legislation) is the way to go, but my hope is people just get it.

Casa acknowledged legislation is often necessary to fund programs.

With legislation comes politics and give and take. Kevin Guskiewicz, professor and co-director of the Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center at the University of North Carolina, said that doesn’t come easy for medical professionals.

“It’s hard for people like us that are medical people to compromise on anything because we think we should have it all,” he said. “So that’s where we’re beating our fists on the table at state capital buildings as we’re debating why we need it all. I did learn a lot about compromise.”

 

Source: ABC News/AP

Protecting High School Athletes From Preventable Deaths (WBUR)

Listen to Dr. Casa’s Interview with NPR here.

 

Doug Casa, chief operating officer of the Korey Stringer Institute, says the highest number of sports-related deaths in the U.S. are among the 7 million high school athletes.

Casa, along with the National Athletic Trainers’ Association, is asking all 50 states to adopt safety procedures to safeguard athletes. Casa joined Bill Littlefield to discuss his efforts to make high school sports safer.

BL: Doug, how many athletes are we talking about in a given year?

DC: In a given year, if we just focus on high school, you usually see between 20 and 30 deaths. We’re also very focused on what we call “catastrophic injuries” that may not lead to death. And those will number in the hundreds.

BL: You focus your study on four causes of death: sudden cardiac arrest, head injuries, heat stroke and complications from the sickle cell trait. How did you narrow it down to just those four?

Testing High School Athletes For Steroids
Kids … find the tests pretty easy to beat,” says the founder of a group that aims to prevent steroid use.

DC: It’s a good question. I mean, the research has shown that those four causes of death actually are about 90 percent of all the deaths that we see in high school and college sports. So it’s not to say there aren’t other things that could be dangerous to an athlete, like lightning strikes or something called hyponatremia or asthma.

But those four that I mentioned, all four of these conditions can be prevented. And in the case of heat stroke, for instance, death is 100 percent preventable if treated properly. And in the case of cardiac conditions, if an AED [automated external defibrillator] is placed on within a minute, they’re 90 percent preventable.

BL: In 2013, I understand that along with the National Athletic Trainers’ Association, you recommended that all 50 states adopt guidelines to protect athletes from sudden death. But in 2015, only 22 percent of states have done that. Why is it so difficult to get everybody on the same page when it comes to something so basic as player safety?

I’ve been an expert witness on 35 cases where deaths have happened in sport … and in almost all the cases, the death was preventable with relatively simple, simple policies and procedures.

– Doug Casa, Korey Stringer Institute

DC: It depends on which particular policy we’re speaking of. I mean, some states have moved forward faster, for instance, like with some concussion policies as an example.But they’ve been a little slower, maybe, with heat acclimatization policies or AED policies. Because at the high school level, you have to change policies on a state-by-state level. It’s not like the NCAA, or the NFL, or professional governing bodies where one organization will influence everyone.

I really think the last three-to-five years have been just a total, monumental shift in the thought process, and we’ve seen a lot of substantial changes. As an example, with heat acclimatization, in 2011 we had zero states that met the minimum guidelines for heat acclimatization, which is kind of the key step to prevent heat stroke deaths. And now we’re at 14 states. And it might not seem like a lot, but of those 14 states, 10 of them are in the Southeast, and we still have not had a heat stroke death in any of those 14 states that have followed those policies. So that’s powerful ammunition for those other states to move forward and adapt some of these policies.

BL: I find it hard to understand how something so commonsensical as “Hey, let’s have some acclimatizing to heat conditions” could ever be controversial anywhere.

We don’t want to stop until we have 50 states, although my wife keeps convincing me we don’t need Alaska for heat acclimatization.

– Doug Casa, Korey Stringer Institute

DC: I wouldn’t say it’s controversial. Sometimes change takes a little bit of time because they have to change what they’ve done for the last 50 years. In high school football they like to start out and have their two-a-day practices, and a lot of times it’s a change of a mindset for them.

So I do agree with you, it’s very common sense, it’s very simple changes and the amazing thing is it costs so money at all. So when we usually get a chance to sit down and meet with them individually, most make progressive changes. Fourteen states meet the minimum standards, but, to give credit, another 20 have made substantial changes in the right direction.

BL: You know, Doug, I haven’t known you for very long but I can tell you are the ultimate “glass half-full” kind of guy if you’re talking about 14 states are on board, and you’re talking about progress. 

DC: Well, I guess my way of looking at it is 90 percent of all heat stroke deaths in America happen in concentrated states in the Southeast region of the country. So probably saving three or four kids lives every summer just by the states we’ve gotten on board — so that makes me feel pretty good for those families. But yeah, we don’t want to stop until we have 50 states, although my wife keeps convincing me we don’t need Alaska for heat acclimatization.

But I mean that’s just one example. There’s a lot of really simple things we can do to keep kids safe. I mean, AEDs is a great example. It’s only $1,000 for an athletic department to have one nearby. Cardiac’s the leading cause of death in sport in America and to have an AED there is almost a foolproof way of saving someone’s life. It’s really a pretty small cost when you think of the benefit.

BL: Especially when you’re thinking in terms of a $60 million high school football stadium.

DC: That, or when you think about the lawsuits that emanate when deaths do occur that are preventable. I’ve been an expert witness on 35 cases where deaths have happened in sport, especially at the high school level. And in almost all the cases, the death was preventable with relatively simple, simple policies and procedures that would have protected that kid that passed away.

 

Source: Only a Game