Medical Supervision of High School Athletics in Chicago: A Follow-up Study

Abstract

Background: High school sports participation in the United States has increased dramatically over the past 25 years. A corresponding increase in the number of injuries has been noted, particularly in contact sports such as football. This has led medical and sports organizations nationwide to advocate for proper medical supervision of athletes at games and practices. Purpose: To gather information from Chicago public high schools to gauge how medical supervision for high school sports has changed in 2017 compared with 2003. Study Design: Cross-sectional study. Methods: Survey questionnaires were sent to the athletic directors of all 99 Chicago public high schools to complete via email. The questionnaire survey contained the same questions as in a survey conducted in 2003 by Tonino and Bollier, with the addition of 4 novel questions relating to emergency action plans (EAPs), automated external defibrillators, concussion management policy, and tackling progression drills. Results: The response rate was 66.67% (66/99 schools). Of the 66 responding schools, all with football programs, no school had a physician on the sideline at home games (decrease from 10.6% in 2003), 37.9% had an athletic trainer present (increase from 8.5% in 2003), and 63.6% had a paramedic available (decrease from 89.4% in 2003). In 2017, 65.6% of responding schools had a coach certified in cardiopulmonary resuscitation (CPR) available at practice to handle medical problems, compared with 89.4% in 2003 ( P < .001). Regarding the 4 novel questions, 93.9% of the responding schools had proper tackling progression drills in place, followed by 89.1% who had appropriate EAPs and 93.9% with concussion management protocols, including return-to-play and return-to-learn protocols. Conclusion: Although significant improvement was found in athletic trainer coverage, especially at games, physician coverage was lacking and fewer coaches were certified in CPR in 2017 compared with 2003. EAPs and concussion management protocols were present in most Chicago public high schools. Overall, greater medical supervision is needed, which we believe should come in the form of increased athletic training and physician involvement and coverage, given that expert, expedited medical care saves lives.

Emergency Action Planning in School-Based Athletics: A Systematic Review

“…Nine studies found that 48% -98% of schools had an AED on campus. [10][11][12][16][17][18][19]23,24 Tennessee had the lowest rate at 48%, while West Virginia high schools had the highest rate of 98% among the states included in the studies. 12,19 Four studies found that 61% -94.4% of schools had an AED available at all athletic venues.…”

“…Nine studies aimed to identify if schools had adopted a formal EAP and demonstrated EAP adoption rates ranging from 55% -100% (Figure 2). [10][11][12][13][14][15][16][17][18] Figure 1. Flow diagram for study selection.…”

“…Percentage of schools with a written EAP. [10][11][12][13][14][15][16][17][18] One study identified 38% of high schools always having an EAP, while 36% have never had an EAP in place. 19 Five studies found that EAPs were rehearsed and reviewed at least annually in 18.2% -91.6% of schools that have an EAP.…”

“…20,21 Two studies identified that only 50% -81% of schools had access to an AT. 11,21 Olympia et al 13 found that 34% of schools have an AT at all athletic events, while Jones et al 10 found that only 4.6% of schools had an AT available for medical problems at practices. Nine studies found that 48% -98% of schools had an AED on campus.…”

‘The Little Engine That Could’: A Qualitative Study of Medical Service Access and Effectiveness among Adolescent Athletics Athletes Competing at the Highest International Level

“…Throughout the world, increasing numbers of adolescents participate in competitive sports, some of them with the ambition to become professional athletes or to qualify to the Olympic Games [ 5 ]. For instance, the past 25 years have in the U.S. seen an increase in student participation in high school athletics from 4 million participants 1971–1972 to 7.9 million in 2015–2016 [ 6 ]. Despite calls from the International Olympic Committee for more research [ 7 ], little is known about health service needs and use among adolescent competitive athletes [ 8 , 9 ].…”