A comparison of medical care between athletic trainers and first responders at North Carolina High School Athletic Association member schools

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Susan C. Edkins (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site: http://library.uncg.edu/
Pamela Brown

Abstract: Despite the recommendation of the American Medical Association, National Federation of High School Athletic Associations, and the National Athletic Trainers’ Association for secondary schools to employ athletic trainers (ATs), only 37% of public secondary schools and 27-28% of private secondary schools (Huggins, et al., 2019; Pike, et al., 2017; Pike, et al., 2016, Pryor et al, 2015) nationwide provide full-time access to an AT. North Carolina Administrative Code (NCAC) requires each school district to designate either an AT or a first responder (FR) for each high school to provide medical care for football and wrestling athletes. Previous research indicates that FRs perceive themselves as lacking the knowledge to manage most of the common causes of death of athletes (Eilbacher, 2010). Without access to an AT, the safety and well-being of secondary school athletes in North Carolina is impacted. A sequential mixed-methods study was conducted. A web-based survey assessed how often ATs and FRs met each of the standards and evaluated differences between ATs and FRs with the elements of the standards. Participants represented ATs (n = 115) and FRs (n = 47) from all eight regions and all four classifications of the North Carolina High School Athletic Association. Follow-up focus groups were conducted with ATs (n = 13) and FRs (n = 3) to determine the barriers and facilitators to meeting the twelve standards. Statistically significant differences between ATs and FRs were found in six of the 12 standards. Significantly more ATs than FRs performed services related to the 19 of the 28 elements of the standards. Knowledge questions related to the most common causes of fatalities in sports revealed that FRs were less knowledgeable about management of exertional heat stroke, cervical spine injuries, and sudden cardiac arrest. Four themes in two categories (personal and organizational) emerged related to barriers to meeting the standards. The personal barrier to meeting the standards, lack of knowledge, was most prevalent with FRs. Organizational barriers to meeting the standards included lack of support, resources and time. Two themes in two categories (personal and organizational) emerged for facilitators to meeting the standards. These themes were relationships and structures. The differences in medical care provided by ATs and FRs combined with the lack of knowledge of FRs, who are not required to work under the supervision of a physician and less likely to have a formal agreement with a physician or an established athletic health care team (AHCT), increases the likelihood of athletes at those schools receiving less appropriate care. Because there is a lack of understanding of the role of ATs (Clines, et al., 2017; Eason, et al., 2019; Felling, 2003; Jaquith, & Hanley, 2018; Mensch, et al., 2005, Weitzel, et al., 2015), it is important to educate the stakeholders about the differences in medical care between ATs and FRs.

Additional Information

Language: English
Date: 2020
Adolescents, Athletic injuries, Athletic training, High school, Medical services, Safety
Sports injuries $x Treatment $z North Carolina
Physical education and training $z North Carolina
High school athletes $x Health and hygiene $z North Carolina
Athletic trainers $z North Carolina
First responders $z North Carolina

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