High School Athletics

Athletic Trainers in the Secondary School Setting

Posted on March 16, 2016May 2, 2016 by Yuri Hosokawa

By Rachel VanScoy, Assistant Director of Sports Safety Policies

Athletic Trainers are health care professionals who work under the direction of a licensed physician and who specialize in the prevention, recognition, emergency care, treatment, and rehabilitation of sports related injuries. A recent study reported that only 37% of high schools in the United States provide full-time athletic training services.¹ Seventy of the public secondary schools acknowledge the importance of athletic training services and provide some level of medical coverage.¹ With the increasing number of sports participation and sports related injuries in the high school setting, it is essential that appropriate medical coverage is available. It is important to understand what services and coverage athletic trainers’ provide.

Athletic trainers do not just provide “coverage” during sporting events but provide quality health care to active individuals on and off the field. During emergencies, athletic trainers are onsite to provide immediate care to potentially life-threatening conditions and are trained to provide prompt treatment to help prevent sudden death (i.e., sudden cardiac arrest, exertional heat stroke). Furthermore, athletic trainers provide a link of communication between physicians, coaches, parents, and school nurses. Care of an athlete not only includes physical care but also psychosocial care. A safe environment is created which can result in an athlete confiding in the athletic trainer. Athlete trainers are trained to recognize potential problems (i.e., eating disorders) and can refer to the appropriate medical or professional services.

Additionally, athletic trainers work towards the prevention of injuries and sudden death. Before participation, athletes are screened using medical questionaries’ and preparticipation physical examinations. Athletic trainers are trained to identify potential risk factors and can make appropriate referrals for further screening. The preparticipation screening also allows athletic trainers to identify at risk individuals (i.e., Sickle cell trait, asthma, diabetes). Risk mitigation can be accomplished though educating parents, coaches, athletes, and administrators, as well as, through injury prevention programs. Off the field athletic trainers develop, practice and implement Emergency Action Plans (EAPS) and Policy, and Procedure manuals. A few examples of the policies that athletic trainers develop are heat acclimatization, concussion, lightning, hydration, and environmental (i.e., cold and hot weather) policies. Athletic trainers are responsible for ensuring policies are implemented and followed.

Athletic trainers provide on and off field services to continually maintain health and safety in sports. Described above are just a few of the many services athletic trainers provide at the high school level. For more information, visit the National Athletic Trainers’ Association (NATA) webpage for the Secondary School Setting.

References

Pryor RR, Casa DJ, Vandermark LW, et al. Athletic Training Services in Public Secondary Schools: A Benchmark Study. Journal of Athletic Training. 2015;50(2):156-162. doi:10.4085/1062-6050-50.2.03.

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

Posted on April 20, 2015April 20, 2015 by Administrator

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

Bishop Lynch High School Athletic Trainer Talks about AEDs

Posted on April 6, 2015September 14, 2021 by Yuri Hosokawa

Written by Mike Hopper, ATC, Head Athletic Trainer at Bishop Lynch High School, Dallas, TX

Bishop Lynch High School is a co-educational Catholic high school that is a member of the Diocese of Dallas and a member of the Texas Association of Parochial and Private Schools (TAPPS). Bishop Lynch is a “Safe Sports School” as recognized by the National Athletic Trainers’ Association. The availability of AEDs on our campus is just one example of Bishop Lynch providing excellence in Athletic Healthcare.

Recently, the question was asked on Twitter by the Korey Stringer Institute “Are you prepared for sudden cardiac arrest? Where is the closest AED from where you are right now?” I took a quick picture on my phone of the unit that is permanently posted on the wall just inside of my Athletic Training Room. That is only one unit that currently sits within those 4 walls. Regularly, there are 3 units that are maintained within that facility, however currently we have 5 units there. Two of these units will be deployed elsewhere on campus in the coming months. KSI was understandably amazed and curious how we had 5 AEDs on our campus. But, we actually have 11 of these units posted throughout our 22-acre campus. So, then the question was: How did Bishop Lynch manage to have that many units on our campus and how can other schools learn from us?

I don’t know the full story, but I will say that we are dedicated to having these units within reach and we are dedicated to having a plan to attack sudden cardiac arrest with immediate response and treatment. When I came to BL in August 2014, we had 7 units on campus. Six of these were posted within athletic facilities. The seventh unit has been moved more than once this school year. BL is in midst of major renovations and that unit has floated multiple times before finding its current place. That location has become its new permanent home as this winter we acquired additional units for elsewhere in the building.

There are currently 9 AEDs deployed on our campus. We have units in our end-zone weight room building that serves the weight room and wrestling room in that building plus the baseball field a short distance away. Conceivably this unit also covers the track and football stadium. The fieldhouse in the corner of the same endzone hosts a unit on the wall providing coverage for the football stadium and track. Outside of the “competition gym” a unit is posted in plain sight that provides coverage for the main gym, the dance studio across the hall, and the weight room upstairs in that same building. Upstairs and a short distance away we have a brand new unit that was recently installed near the business office and two classrooms. Our “Legacy Gym” sits just feet away from the new “competition gym” and hosts a unit of its own posted on the wall outside our satellite Athletic Training Room. As we begin to enter the academic end of campus, we have a unit (previously mentioned) that sits outside of the theater. This is also located close to the main office and the cafeteria. Another brand new unit was deployed recently and is now posted on the wall right outside of the nurse’s office. This gives us 7 units posted in permanent locations.

Two more units are located inside of the Fieldhouse Athletic Training Room and these units are portable. This allows the Athletic Training Staff to transport the AEDs to the sideline or dugout of games. Our softball team currently plays off-campus and we are able to take a unit to their games without jeopardizing the safety (and liability) of our campus. We also take an AED with us whenever we travel with our football teams. With approximately 150 people that make up our travel party for a varsity football game, we believe that carrying this unit is necessary at all times.

I currently have two more units sitting in my office that are brand new and still inside of their boxes along with their cabinets. These units are awaiting the completion of new construction. One unit will be installed in the coming weeks as we prepare to open up a new building with 12 classrooms and the last unit will be installed before the 2015-2016 school year when that phase of renovations is completed.

I know that in our athletic facilities we are less than a minute from an AED at all times. There is not a single place that somebody can’t have an AED in hand instantly. The furthest point from an athletic standpoint from an AED is centerfield on the baseball field to the Haggar Building AED in the endzone. That is approximately 500 feet away. But on a game-day, there is a unit in the home dugout cutting that distance down by about 100-150 feet. Academically, we are currently a little bit further away than that in a couple of locations, however that will change in a couple of weeks. Our new unit will cut down that distance significantly. My biggest concern is in our parking lots, which are at the far ends of our campus. Just the other day I brought up this concern to our security staff and we will be addressing this.

Great, so you have 11 AEDs on campus? But do you have staff to use them?

This is a great question. While the AEDs are simple enough to be used by just about anybody, it is still critical that trained personnel respond to a sudden cardiac event. Accordingly, and as required by TAPPS, our entire coaching staff is required to maintain current CPR/AED certification. Additionally, we have a school nurse on campus each day along with one full-time Certified Athletic Trainer and one part-time Certified Athletic Trainer. Our security staff also is required to maintain CPR/AED certification. So in short, we have staff onsite at all times trained to respond to a cardiac event.

How do you maintain 11 AEDs? Who is in charge of that and who pays for that?

This is another great question. And one that we recently figured out. We have three units that are 4 years old, four units that are 3 years old and four units that are brand new. In the past, the replacement pads were simply purchased out of an account and nobody really thought about it too much. But as you can imagine, with 11 units, this is a costly venture. And so the school nurse and I have asked for a specific answer moving forward. We did not want this to be a year-by-year decision. Basically, each year we will spend the equivalent to what it would cost to purchase a new unit every year. But it’s a small price to pay and our school administration agrees with this. For this reason, the nurse’s budget will grow each year to accommodate this specific expense. We share joint responsibility for proposing those needs each year and I have taken on the responsibility of maintaining the units. This includes walking past them throughout the week along with testing them once a month. I have made up a spreadsheet with our entire inventory that includes expiration dates and also have a checklist in each case that I check off each month.

11 AEDs, a full staff of trained personnel, emergency action plans for athletics and campus-wide, combined with EMS being located only minutes away and the major trauma center less than 15 minutes away, we believe that Bishop Lynch is well-prepared for a sudden cardiac event on our campus. While we hope to “waste” a lot of money over time, we believe it’s a small price to pay should somebody on our campus collapse.

Every Athlete Deserves an Athletic Trainer. Every Friar Athlete Has One.