ShareThisHigh school athletes sustain 2 million injuries practicing and playing sports each year.
About 30,000 of those injuries are serious enough to require hospitalization. And according to the National Athletic Trainers' Association, 40 to 50 student athletes die from sports injuries every year.
Although the athletic trainers aren't everywhere they're needed -- only about 40 percent of schools have even one around campus more or less full time -- their profession is at the front lines of treating and preventing injuries.
This week, for the first time, NATA named the 10 most deadly threats to young athletes, with guidelines on how to respond if a player goes down.
The 23-page position paper on "Preventing Sudden Death in Sports" is neither a medical guide nor a definitive research collection, but more a heads up for medical professionals, coaches, parents and others trying to protect young athletes.
Kevin Guskiewicz, one of the paper's authors and an athletic trainer and University of North Carolina-Chapel Hill researcher on sports trauma, said such guidelines are essential when national efforts are focused on increasing kids' physical activity.
While athletic trainers are best suited to managing life-threatening situations on the field or court, the guidelines urge that coaches have basic training in first aid, CPR and use of automated defibrillators to initiate care: "Delaying care until the ambulance arrives may result in permanent disability or death."
The entire document will be published in the February Journal of Athletic Training. It appears online at www.nata.org under "statements," then "position statements."
Some of the key messages:
-- Every team, coach, competition and practice site needs an emergency plan that includes call lists, first-aid training and a route mapped for an ambulance to get there.
-- Concussions account for several million sports injuries each year. Any player with a concussion should be examined to determine how severe the injury is, particularly in situations where players sustain a second hit in quick succession.
-- Sudden cardiac arrest, though not always documented, is believed by many to be the deadliest event in sports. The heart can be stopped by a blow to the chest, but cardiac arrest more likely is the result of an undetected heart defect. Any athlete who collapses and is unresponsive needs to be hooked up to an automated defibrillator within three to five minutes.
-- Heat injuries start off the playing field -- two-thirds of kids show up for practice dehydrated. Exertional heat illness -- heat stroke -- is most common during the first days of football season and overweight or obese players are at greatest risk. But kids doing a lot of conditioning with too few breaks and too little water can be affected. The only sure way to measure core body temperature is with a rectal thermometer. Don't wait for medics to start cooling the athlete. Faster cooling begins with an ice bath, or at least cold towels.
-- Anyone with sickle cell trait can be at risk for exertional sickling, a breakdown in blood cells that can quickly destroy muscle tissue. While the genetic trait-- passed down because it can protect against malaria -- is most common among African-Americans, it can be found in any ethnic group with roots in malarial zones. Athletes with the trait can play any sport, but their exercise may have to be closely monitored or reduced in heat, at high altitudes or at particularly high intensity.
The guidelines also cover management of athletes with chronic conditions including asthma and diabetes, cervical spine injuries, injuries from head-down contact in football, water intoxication (dangerously low salt levels from over-hydrating) and preventing and responding to lightning injuries.
(Contact Lee Bowman at BowmanL(at)shns.com.)
MEDICAL JOURNAL
