More than 7.8 million high school students participate in sanctioned sports each year. A recent national survey by the Korey Stringer Institute shows that many states are woefully behind in addressing the major causes of sudden death for that age group. The Korey Stringer Institute is a sports safety research and advocacy organization named after the former Minnesota Vikings football star who died from exertional heat stroke (EHS) in 2001.

The state-by-state survey of all sports played in high school showed North Carolina with the most comprehensive health and safety policies at nearly 80 percent of the best practice guidelines. At the bottom were Colorado (23 percent) and California (26 percent). The policies address four major causes of sudden death for that age group: cardiac arrest, traumatic head injuries, EHS and exertional sickling—the deformation of red blood cells that can occur in athletes with sickle cell trait.

Wake Forest Baptist Medical Center's Bob Gfeller is the executive director of the Childress Institute for Pediatric Trauma. In 2008, his son Matthew died at age 15 after he sustained a traumatic brain injury playing football for Reynolds High School in Winston-Salem.  

Gfeller spoke with WFDD's David Ford about how North Carolina programs fare in the study, and what lies ahead.

Interview highlights

On how the study was scored:

When you look at the rubric, there's five components—each component had a maximum score of 20—and the whole thing is focused on execution of protocols to prevent sudden death in youth sport. So, [the components are] sudden cardiac arrest, dehydration, traumatic brain injury, sickle cell activation, and the emergency action plan. The reason that those five were chosen is that they drive 90 percent of sudden death in youth sports.

On what North Carolina is doing right:

The median score was a 47, so, for North Carolina, we definitely want to be proud of our score [79] because it was number one, and at the same time we need to know that there's 21 more points that we can close on this matrix or rubric. What we had was a very balanced score—across all five of the categories.

On the associated costs involved:

In order to score 100, it doesn't require a massive investment by the school system or athletic association to get there. The easy example is to do really well in the handling appropriately of dehydration, it really requires the appropriate tub at the school. So, if a child's body temperature is above 103 [degrees], you have the equipment there to very quickly get the child to where they need to be—which is 103 degrees or less—before they're transported to a hospital. The biggest expenses are AEDs [Automated External Defibrillators] to handle sudden cardiac arrest, cooling tubs to handle dehydration, [and] as it relates to concussion, equipment-wise, most of it is in the equipment [that a school has] already. Sickle cell is observational and [depends on an] understanding of your athlete base. And then emergency action plan is really no cost. So, it is a low cost. 

On areas for improvement in North Carolina:

One of the things that struck me was in the traumatic brain injury space which is the space that I focus on. When you look at proper blocking and tackling in football, there are really three states that have mandated coaching training in proper blocking and tackling, and that's one thing we in North Carolina haven't done. I'm not saying it's something we should do, but when you look at the way the matrix was scored, the Heads Up [Football] program that is sponsored by the NFL, and youth football is using it. Frankly, we at the Childress Institute and the Gfeller Center administer these programs locally, but that's a gap for us. It's a gap for most of the states in the country because it's very time consuming, and there is some cost potentially in it. But you can access that through the USA Football, and the NFL and the CDC. So, that was one thing that sticks out as an opportunity for us to continue to spend time training our coaches on proper blocking and tackling in football, proper equipment fitting, and then the other thing is expanding beyond boys and football. Because soccer and girls, and field hockey and girls, and basketball for girls and lacrosse for boys and girls—all these sports—have concussion risk. So, there's a fair amount more to be done, particularly on the research front.  

 

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