Emergency Preparedness in High School–Based Athletics: A Review of the Literature and Recommendations for Sport Health Professionals

Abstract

Approximately 7.6 million high school students in the United States participate in sports. Although most sport-related injuries in adolescents are considered minor emergencies, life-threatening illnesses or injuries may occur, such as sudden cardiac arrest, heat stroke, status asthmaticus and exercise-induced asthma, catastrophic brain injuries, cervical spine injuries, heat- and cold-related illness, blunt chest/abdominal injuries, and extremity fractures resulting in compartment syndrome. Emergency preparedness in athletics involves the identification of and planning for medical services to promote the safety of the athlete, to limit injury, and to provide medical care at the site of practice or competition. Several national organizations have published guidelines for emergency preparedness in school-based athletics. Our article reviews guidelines for emergency preparedness put forth by the Sideline Preparedness collaboration (comprised of 6 major professional associations, including the American Academy of Family Physicians, American Academy of Orthopedic Surgeons, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine), the National Athletic Trainers' Association, the American Academy of Pediatrics' Committee on School Health, and the American Heart Association. Additionally, we review published data examining compliance of US high schools with these recommendations for emergency preparedness in school-based athletics, determine deficiencies, and provide recommendations for improvement based on these deficiencies.

Compliance of Camps in the United States With Guidelines for Health and Safety Practices

“…[15][16][17][18][19] In terms of wilderness activities, deaths have been reported in children associated with hiking, swimming, and river rafting, resulting from drowning and closed head injury. 24 Although most sport-related injuries are considered minor emergencies, life-threatening events may occur, 25 such as sudden cardiac arrest/commotio cordis, [26][27][28][29] heat stroke, 30,31 status asthmaticus, 32 catastrophic brain injuries, [33][34][35] cervical spine injuries, 36 and extremity fractures. 22,23 Although pediatric hospitalization rates for drowning have decreased during the past few decades, drowning remains the second leading cause for unintentional injury death among children, accounting for more than 1000 deaths per year.…”

Implementation Science: Lessons Learned From Evaluating Practice Recommendations for the Care of Patients With Spine Injuries

“…Further, the National Association of State EMS Officials recommended that ATs and local EMS regularly practice the EAP together in drills to strengthen, plan execution of, and ease transition of care during an actual emergency, 30 a position that has been supported by others. 26,27,31,32 Frequent practice not only builds a relationship with EMS but also makes execution of the EAP more efficient and provides opportunities to identify concerns or problems with the plan that can be improved for better delivery in future emergencies. Targeted strategies that provide practical examples and real-world tips to ATs on how to build strong relationships between EMS personnel and ATs should be developed to support the implementation of practice recommendations because the lack of such a relationship may hamper uptake.…”

Management and Prevention of Sport-Related Concussion

“…61,62 They are designed and implemented by trained medical and allied health professionals and are encouraged for all athletic venues; these plans should be activated when responding to the concussed athlete who is unconscious, convulsing, or has an altered mental status, as it is difficult in these situations to rule out other potentially catastrophic injuries. [62][63][64] Often, the presentation of concussion is more subtle. 61,62 Further details regarding EAPs are available elsewhere in the medical literature.…”