Exertional Heat Stroke and Emergency Issues in High School Sport

Abstract

Every year, recreational, high school, collegiate, and professional athletes die as a direct result from sport participation (7). The primary causes include cardiac arrest, head injuries, exertional sickling, asthma, and exertional heat stroke (EHS) (7). A recent article published in the NATA News (3) highlights the sudden deaths of young athletes, where in 2008 alone, they recount 12 high school football players died, along with 2 youth-leaguer football players and 2 soccer athletes (3,7). Although there are many causes of sudden death in sports, schools with sanctioned athletic events need to be prepared to prevent, assess, and treat these medical emergencies. The most appropriate individual to manage a medical emergency situation on a daily basis at the high school level is a certified athletic trainer. Certified athletic trainers (ATs) are allied health care professionals specially trained in the prevention, recognition, treatment, and rehabilitation of athletic injuries within the physically active. The National Athletic Trainer’s Association (NATA) encourages all secondary schools to have a comprehensive athletic health care system in place, which includes having a school physician and an on-site AT to provide appropriate medical care. Secondary schools that fail to implement the recommendations made by the NATA regarding appropriate medical care for the secondary-aged athlete places the medical care into the hands of an untrained individual and implementation of the school’s emergency action plan (EAP) ultimately becomes the responsibility of the athletic director, strength and conditioning staff, and coaching staff. The EAP is a document that outlines the care an athlete should receive when a medical emergency arises and should include all personnel involved in the care of the injured athlete and include a discussion of all the potential causes of sudden death. Despite having an EAP in place, secondary schools without appropriate medical care providers on-site are at risk for common errors, such as delay in care, misdiagnosis, and improper treatment, which can lead to death, as was seen with the high-profile tragic death of Kentucky High School football player Max Gilpin in August 2008.