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'Best Practice' Policies Focus on Preventing Student-Athlete Deaths

By guest blogger Gina Cairney

Sudden death in athletes is rare, but according to a task force of leading health professionals, secondary school athletes lead the country in athletic-related deaths, most of which can be prevented through proper education, emergency protocols, and health and safety policy considerations.

During its 64th annual conference in Las Vegas today, the National Athletic Trainer's Association provided an advance release of "best-practice" policies that can be adopted universally by all secondary school athletic programs in the United States. The statement will be published in the July issue of the Journal of Athletic Training.

These "best practice" policies build on NATA's position statement from two years ago addressing a wide range of youth sports-related issues, which my colleague Bryan Toporek has written about previously.

The task force document, "Preventing Sudden Death in Secondary School Athletics Programs: Best-Practices Recommendations," is a roadmap for policy considerations regarding health and safety in secondary athletics programs, and looks to address the leading causes of sudden death among student athletes, including head and neck injuries, heat stroke, and sudden cardiac arrest.

To ensure student safety, the task force recommends every school develop an Emergency Action Plan that includes specific details for each athletic facility where practices and competitions occur. The statement also suggests all administrators and athletics staff who have contact with youth-athletes be certified in first aid and CPR.

To minimize incidents of exertional heat stroke and other injuries, school athletic programs should also develop a program that acclimatizes youth athletes to hotter seasonal temperatures through phases of exercise intensity, duration, and total practice time.

Any secondary school that sponsors contact or collision sports like football and soccer should employ an athletic trainer, the task force suggests. The athletic trainer would consult with a team physician or treating physician and make decisions on an athlete's ability to participate following an injury incident such as a concussion.

As another preventative measure, perhaps with bigger consequences than those for concussions and heat stroke, the task force suggests that all students undergo cardiovascular screenings prior to participating in school athletics in an attempt to identify students who may be at risk for sudden cardiac arrest.

The Centers for Disease Control and Prevention estimates that about 66 athletes die from a sudden cardiac cause each year in the country, and although the average number of youth athletes who die from such causes is very small(less than 100 per year), it's enough to set off alarm bells among parents and youth-sports safety advocates.

The task force says in its statement that it supports using the American Academy of Family Physicians' minimum screening standards, and a 12-lead electrocardiogram when necessary. The screening standards would pull information from a student-athlete's family health history, personal history, and physical exams.

However, a lack of solid guidelines and follow-through with health screening standards have left many student-athletes at risk of suffering from a sudden cardiac arrest.

Bryan also wrote two years ago about the lack of compliance among athletic directors and doctors in meeting national cardiac screening guidelines.

In 2007, the American Heart Association recommended a 12-step screening process to prevent cardiac arrest in youth-athletes, but according to the organization's survey of over 3,000 pediatricians, family doctors, and athletic directors, less than 6 percent reported following national screening guidelines which includes asking questions about chest pain during exercise and family medical history.

High school athletes suffer about 2 million injuries each year, according to the Dallas-based Youth Sports Safety Alliance's statistics, and history of injury is a risk factor for future incidence and severity of injuries, making preventative safety measures in secondary school athletics even more crucial.

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