The
Secondary School Football Coach’s Relationship with the Athletic Trainer and
Perspectives on Exertional Heat Stroke.

Adams WM, Mazerolle SM, Casa DJ, Huggins RA, Burton L. J Athl
Train
. 2014;49(4):469-77. DOI: 10.4085/1062-6050-49.3.01

Take Home Message: High school football coaches are confident in
their ability to handle exertional heat stroke but their knowledge is limited in
this area. The coaches value and understand the role of athletic trainers.

The National Athletic Trainers’ Association recommends that appropriate medical coverage be provided in the secondary school setting. Many schools have no
coverage and in other cases have opted to place coaches in charge of the
medical care. Exertional heat stroke (EHS) is a preventable illness, however, if coaching staff are not
fully aware of the precautions, signs, and symptoms of EHS, this particular
heat disorder can become life threatening. Therefore, the authors of this study
investigated secondary school football coaches’ perceived knowledge of
treatment and prevention of EHS as well as their relationship with athletic
trainers. Participants from numerous states completed an online interview that
consisted of three sections, including: 1. demographic information; 2. open-ended
questions asking about each coach’s experience dealing with emergency
situations, and; 3. closed-ended questions to assess professional
relationships. Of the 38 coaches who responded to the survey, 24 (63%) felt
that they were prepared to handle an emergency situation. Many of the coaches
were unable to recognize all of the signs and symptoms of EHS. A total of 92% of coaches identified dizziness
as the main sign, while only 32% identified central nervous dysfunction, which
is the most prevalent sign. When asked about prevention, 66% mentioned frequent
water breaks, and of those, 72% stated that water breaks were the only
prevention strategy they used. When asked about the athletic trainers, one
coach stated that ‘‘without an athletic trainer present, our programs and the
coaches will be at a disadvantage, and the health of the student-athletes would
be at a higher risk level.’’ When asked about an athletic trainers’ qualifications,
a coach commented, ‘‘for diagnosis, immediate care, and prevention and also for
treatment and clearance to resume play.’’ Coaches demonstrated fundamental
knowledge regarding an athletic trainers, however, they did not mention acute
or emergency care.

Athletic trainers and coaches are both vital caretakers that are a
part of the sports medicine team and need to work with one another to give the
best possible treatment for the athlete, and provide an optimal and safe
environment for play. Athletic trainers can help navigate and treat an athlete
in areas where coaches may lack knowledge about EHS. When young athletes are
learning different techniques in football at the secondary school level, an
issue can arise if the coach is not properly educated in the care of a player during
an emergency. Coaches should be competent in CPR, first aid, and dealing with various
types of heat illness. This will benefit the athletes and keep their safety in perspective.
This should be the primary concern for all sports, including football. For
athletic trainers, it is to their benefit for coaches to be familiar and
mindful of the dangers of EHS. When emergency situations arise they need to be
handled in a timely manner and this is not possible if the signs are not
recognized. To treat and prevent injury is one of the many responsibilities of the
sports medicine team, and EHS is preventable. We must work together to ensure
our entire sports medical team is prepared for any emergency. It will be
interesting to see how the relationship between coaches and athletic trainers
grow into more of a friendship with constant communication, rather than just
strictly professional conversations when needed. The more communication athletic
trainers and coaches have, the more aware both parties are and the more
positive environment for all the athletes. 

Questions for Discussion: How can coaches and athletic trainers optimize injury prevention and management? Should secondary schools require coaches to attend inservice meetings to discuss injury recognition & management?

Written By: Yanira Dawson, Crystal Petrus, Savannah Kuester
Reviewed by: Kim Pritchard

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Adams, W., Mazerolle, S., Casa, D., Huggins, R., & Burton, L. (2014). The Secondary School Football Coach’s Relationship With the Athletic Trainer and Perspectives on Exertional Heat Stroke Journal of Athletic Training, 49 (4), 469-477 DOI: 10.4085/1062-6050-49.3.01