Certified Athletic Trainers in Secondary Schools: Report of the Council on Scientific Affairs, AMA
Abstract & commentary
Synopsis: Certified athletic trainers, working under the direction of the school’s volunteer physician, can fill the need for ongoing prevention, emergency care, and rehabilitation of athletic injuries in high school athletes.
Source: Lyznicki JM, et al. Certified athletic trainers in secondary schools: Report of the Council on Scientific Affairs, American Medical Association. J Athletic Training 1999; 34(3):272-276.
Lyznicki and colleagues emphasize the need for greater medical coverage for our large group of high school athletes (estimated to be 6 million). At present, the prevention, recognition, and initial emergency care of the injured high school athlete often falls on the shoulders of the team’s coach. However, only 28 states require educational programs in sports first aid and safety for high school coaches. The National Athletic Trainers Association (NATA) estimates approximately 1.3 million high school athletes (1 in 5) are injured each year, and while 70-75% of these injuries are minor (sprains, strains, and contusions), the risk of catastrophic injury in high school sports has been estimated to be 1 in every 100,000 participants.
Prompt recognition of an injury with execution of appropriate emergency procedures can reduce the injury’s long-term effects and shorten recovery time. Volunteer physicians attend most high school football games and are often present at basketball games. However, Lyznicki et al remind us that 60% of all injuries occur during practices, and it is typically impossible for these volunteer physicians to be at all practices. Certified athletic trainers, working under the direction of the school’s volunteer physician, can fill the need for ongoing prevention, emergency care, and rehabilitation of athletic injuries in high school athletes. However, financial constraints often limit the ability of a school to hire a certified athletic trainer as part of the athletic staff. In a 1996-1997 survey of the National Federation of State High School Association, only 13 states reported more than 50% of high schools had a certified athletic trainer on staff for football, and in only six states were there more than 50% of schools with a certified athletic trainer on staff for basketball. This survey did not estimate the number of schools that had a full-time certified athletic trainer available to all high school sport participants. In 1997, the American Association of Pediatricians introduced a resolution asking the American Medical Association to support efforts to have certified athletic trainers as part of the athletic staff in all secondary schools. The AMA House of Delegates in June 1998 responded favorably to this resolution.
Comment by Letha Y. Griffin, MD, PhD
In the United States, the smallest group of athletes, (i.e., the professional and collegiate athletes) has the greatest access to medical care. Unfortunately, one of the largest groups of athletes in the United States, the junior and high school athletes, frequently has no one available on a day-to-day basis to advise them on issues such as sports nutrition, conditioning techniques, proper fitting of sports equipment, and other aspects of injury prevention, nor do they have someone on-site to provide emergency first aid and arrange appropriate transport for acute injuries. Certified athletic trainers, if hired by the schools, can provide this support to students. Moreover, they can serve as a vital link between physicians, players, parents, and coaches. By compiling accurate injury reports, they can ensure that appropriate epidemiological data are available to analyze injury trends and risk factors for injury and, hence, to assess the effectiveness of therapeutic and prevention programs.
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