Original Article

Medical Coverage of High School Athletics in North Carolina

Authors: Douglas F. Aukerman, MD, Melissa McManama Aukerman, MS, Douglas Browning, MD, ATC-L


Background: A significant percentage of high school students participate in athletics, and of those participating, at least one third will experience a sport-related injury. Despite the high risk of injury, there are few guidelines on what type of medical coverage should be provided for high school athletics. Although vague recommendations are present, it is not known to what extent high schools comply with these guidelines. The primary objective of this cross-sectional study was to assess the quality and extent of medical coverage at high school athletic events in North Carolina.

Methods: A questionnaire, mailed to all athletic directors at public and private North Carolina high school members of the North Carolina High School Athletic Association, was used to assess medical coverage.

Results: Only 56% of the schools had coverage by either nationally or state certified athletic trainers. Although 71% of schools had physician coverage at some athletic events, less than 10% of physician coverage included monitoring of athletic practices. Only 27% of the schools surveyed felt that their existing medical coverage of athletic events could be considered adequate.

Conclusions: These preliminary findings suggest that medical coverage of high school athletics in North Carolina, as in other states, is lacking and inconsistent.

Key Points

* The majority of high schools that participated in this study did not have physician coverage of sporting events other than football games.

* Most of the coaches at the participating high schools did not have CPR or first aid certification.

* Only about half of the high schools employed board certified, licensed sports medicine personnel (e.g. ATC-L). The remainder of these schools relied on unlicensed personnel, such as teachers and coaches to provide sports medicine care.

* Adequate sports medicine care of high school athletes, including qualified physicians and licensed athletic trainers, will assist in 1) decreased injury rates, 2) decreased loss of playing time due to accurate diagnosis and treatment, and 3) decreased rate of re-injury due to proper rehabilitation.

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