EMS standby at football games: EMS1 Poll Results

We asked EMS providers about the presence of ambulances at games, the personnel available and their training to treat sports-related injuries

More than a million children and teens participate in organized football in the U.S. Their practices and games take place in communities of all sizes, which are represented by every conceivable EMS response model.

After the lengthy EMS response was mentioned in the news of a Texas high school student's death during a game, we asked readers about EMS coverage and response to injured football players.

Here are the results of the survey.

Does your department provide at the field standby of an ambulance for high school football games?

This was a qualifying question for the survey. Sixteen percent of respondents answered "No" or "Don't know" and were unable to answer the remaining questions.

Respondents who selected "Yes" were able to answer the full survey. Though for unknown reasons on each of the following questions a third to half of respondents did not answer.

Who pays for at the field standby of an ambulance?

Posting an ambulance at a football game, especially if EMS personnel are paid, is an expense. Nearly a third of responses indicated the school or school district pays for the ambulance standby. More than 50 percent though don't bill for standby.

What is the minimum certification level for standby EMS personnel?

More than half of the responses selected "EMT" as the minimum certification level for football game standby. For special event or contracted services, EMS agencies might have latitude to staff an ambulance differently than if they are working on a 911 contract.

Has additional training been completed for football players?

More than one-third of responses were "No" or "Don't Know." The National Athletic Trainers Association has long advocated for joint training between EMS and athletic trainers because of overlapping training and response, as well as the unique equipment — helmets and shoulder pads — worn by football players. That equipment significantly impacts access to a player's chest, neck and face and the capability to provide lifesaving cardiac care and airway management.

Read more about collaborative training and response with athletic trainers.

Has your department jointly trained with athletic training staff?

In the previous question 64 percent of respondents reported completing additional training for injured football players, but in this question more than half of respondents say that they have not trained jointly with athletic trainers or sports medicine staff. Perhaps for those respondents there are not athletic trainers at their games or they have a clear delineation of roles and patient hand-off.

What additional medical providers are available?

It is reassuring that almost 90 percent of respondents reported a certified athletic trainer was also available at games. This is the person that EMS needs to collaborate with on preplanning of EMS response, player care and training. Though it is worth remembering that nearly 40 percent of the respondents that saw this question provided no answer to the question.

The role of a chiropractor, reported as present by 5 percent of respondents, to assess and treat injured football players is not clear.

Who has return-to-play authority?

Return to play decisions, especially for injured players that are not transported to a hospital, are complex and highly dependent on the player's injury. The return-to-play decision seems best suited for an athletic trainer (47 percent) or sports medicine physician (20 percent). Coaches have return to play authority according to 18 percent of responses.

Several respondents mentioned the important and necessary role for parents or guardians to be involved in a return to play decision.

Do you have protocols or specific training for injured football players?

This check all that apply question was an attempt to ask about protocols specific to injured football player care, but based on the high number of responses relative to previous responses on joint training and specific football player training it is possible many respondents were considering their existing medical and trauma protocols.

Hyperthermia and heat illness is regularly cited in news reports of player death and severe illness, especially in late summer preseason practice. Only 45 percent of respondents indicated a football player specific protocol for hyperthermia.

Additional comments and questions

What do you see in these results? What additional questions do you have about EMS standby at high school football games? Share your questions and experiences in the comments. 

Further reading:

Medics, athletic trainer save Texas teen athlete

Beyond backboards: Moving and extricating trauma patients

Hyperthermia: EMS assessment and management

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