New research published in the Journal of Athletic Training has revealed that high
school students who have access to athletic training services are more likely to request
emergency medical services for sport-related injuries. The authors*, including exercise science and health promotion, education, and behavior faculty/alumni as well as collaborators from other institutions, interpret these
findings as a sign of improved identification and triage of sport-related emergencies
and evidence of the need for dedicated athletic trainers at all middle and high school
“Seventy-nine percent of catastrophic sport-related injuries and fatalities occur
in high school athletes,” says Rebecca Hirschhorn, a 2020 graduate of the Arnold School’s Ph.D. in Exercise Science program and an assistant professor of professional practice at Louisiana State University.
“Yet only 66 percent of U.S. secondary schools – ranging from 13 to 90 percent depending
on which state you live in – have access to athletic training services.”
Previous research has found that schools with limited or no access to athletic trainers
are unlikely to have the proper steps in place to respond to a sport-related emergency.
Some schools (49 percent of private and 80 percent of public high schools) try to
compensate for their lack of athletic training services by having coaches, volunteers
or other health care providers present during athletic competitions (not practices),
but these individuals do not have the same training and clinical expertise that athletic
With this study, which was a part of Hirschhorn’s dissertation project, the researchers
used national EMS data and linked it to athletic training data for all public and
private secondary schools in the country. They broke down their findings by zip code
– nearly 5,000 of them.
The authors demonstrated that areas without access to athletic training services were
less likely to request local EMS for treating sports injuries. This was true compared
to areas where athletic trainers were hired part-time or full-time.
They concluded that having access to an athletic trainer resulted in EMS being requested
more often than in areas without access to an athletic trainer. Additionally, they
highlighted that their findings “suggest possible indirect benefits to having athletic
trainers employed, which would include non-school based sports activities.”
Laws and regulations for emergency preparedness only focus on school-based sports.
This means that athletes who participate in sports outside of their school do not
have the same support when it comes to handling emergencies.
“Reliance on untrained personnel to recognize and triage sport-related emergencies
puts athletes at risk of delayed or improper emergency care,” Hirschhorn says. “Even
more concerning, coaches tend to be more confident than they are knowledgeable regarding
how to handle sport-related emergencies. Our findings suggest that athletic trainers
are better able to recognize conditions that require emergency medical services.”
*Authors include Rebecca Hirschhorn (Louisiana State University), Robert Huggins (University
of Connecticut), Zachary Kerr (University of North Carolina Chapel Hill), Jim Mensch (Exercise Science), Thomas Dompier (Lebanon Valley College), Caroline Rudisill (Health Promotion, Education, and Behavior), and Susan Yeargin (Exercise Science).