National Athletic Trainers’ Association Publishes Recommendations on Preventing Sudden Death in Sports

Monday, February 20, 2012
DALLAS, February 20, 2012 – In an effort to prevent the onset of catastrophic or fatal outcomes from sports participation, the National Athletic Trainers’ Association has published a new position statement that outlines 10 major health conditions and causes of sudden death among athletes along with recommendations on management and treatment of sports injuries. “Preventing Sudden Death in Sports” is published in the February 2012 issue of the Journal of Athletic Training, NATA’s scientific publication. It is the first time an association has provided this condensed information in one document to help medical professionals, coaches, parents and others make more effective and efficient return-to-play and care decisions.
 
“These guidelines were developed for any level of sports participation and to truly help save a life” says Marjorie J. Albohm, MS, ATC, president of the National Athletic Trainers’ Association. “It is also critical that a school, team or league’s medical professionals have an emergency action plan in place. In the event that an injury occurs, every minute counts when it comes to appropriate care and transport of the athlete.”
 
“While collegiate and professional teams have athletic trainers on staff to prevent and treat injuries, only 42 percent of high schools have access to our members,” adds Albohm. “Legislation is improving though with 35 states and Washington, DC, having passed youth sports safety laws. And the NFL just mandated new guidelines requiring athletic trainers in booths during games to watch for hard hits and concussions.”
 
Highlights of Position Statement
 
While the position statement details numerous recommendations for preventing sudden death in sports, here are a few highlights:
 
  • Established, site-specific emergency action plans greatly improve the likelihood of survival.
  • Recognition is key to treatment: sudden cardiac arrest should be suspected in any athlete who has collapsed and is unresponsive. 
  • Public access to early defibrillation is essential: a goal of less than 3-5 minutes from the time of collapse to delivery of the first shock from an AED is strongly recommended.
  • When a serious brain injury is suspected in a non-responsive athlete, the medical staff must be prepared to transport the athlete to a medical facility, while ensuring adequate ventilation and elevating the head to help decrease intracranial pressure.
  • Proper management of a less serious brain injury, such as a concussion, must still be managed carefully using follow up assessments of symptoms, neurocognitive function and balance, prior to initiating a gradual return-to-play progression.
  • Cool first, transport second: immediate cold water immersion is critical to reducing the temperature rapidly and maximizing odds the individual will survive.
  • Determine core body temperature soon after collapse to ensure accurate and immediate assessment of a patient with suspected exertional heat stroke.
  • Know the signs and symptoms of exertional sickling and be able to differentiate exertional sickling from other causes of collapse.
  • Understand that exertional sickling can be brought about through intense, sustained activity, and modifying factors of environmental heat, dehydration, asthma, illness and newness to altitude increase the intensity of the activity.
  • The sports medicine staff should make sure athletes with asthma are properly educated about their condition, including adherence to medications, proper use of inhaler equipment and how to recognize “good or bad” breathing days to prevent asthma exacerbations.
  • A structured warm-up protocol may potentially decrease the risk of an exacerbation or reliance on asthma medications.
 
This statement was advance released at the Youth Sports Safety Summit in December 2012. The Summit was spearheaded by NATA and supported by the Youth Sports Safety Alliance, comprising 70 organizations dedicated to keeping athletes safe. Conditions addressed in the statement include: asthma, catastrophic brain injuries, cervical spine injuries, diabetes, exertional heat stroke, exertional hyponatremia, exertional sickling, head-down contact in football, lightning and sudden cardiac arrest.