Proceeding without precaution

With injuries such as concussions on the rise, concern grows over the lack of athletic trainers at high schools

May 20, 2007|By Ken Murray | Ken Murray,SUN REPORTER

The Dulaney sophomore midfielder lay curled in a fetal position after being knocked out by a vicious check. His coach, the first to reach the injured lacrosse player, called 911. Then they waited 20 minutes for an ambulance to arrive.

For Dulaney coach Jake Reed, the consequences of not having a trainer present were scary. The state only requires medical personnel at football games.

"As a coach, [I am] not a trained medical person," Reed said. "There is a fine line between whether a kid just got hit hard or whether he had a head injury. Unfortunately, we're thrust into that role [of deciding] because every kid is different."

He's not alone. Only 36 of 83 public high schools in Baltimore City and surrounding counties have certified athletic trainers or access to one on a regular basis, a Sun survey found.

None of the 19 public high schools in Baltimore City has a trainer. Neither do any in Harford County. Only 12 of 24 public high schools in Baltimore County have one. At the other extreme, Howard County has an athletic trainer for each of its 12 schools.

"It's a tragedy waiting to happen, that the care isn't given quick enough or that something is done [inappropriately] to an injured person," Reed said.

No state requires a certified athletic trainer for every high school.

Dulaney had an athletic trainer as recently as two years ago. She left to enter private business. On the day earlier this season that Dulaney's Matt Culloty was knocked unconscious and forced to lie on the field in bitter cold conditions, the lack of a trainer was evident.

The Dulaney coach, athletic director and principal huddled with an emergency medical technician who was in attendance but not working. They reviewed protocol with Culloty's parents, covered him with blankets and kept him motionless.

The initial fear was a serious neck injury. Not until Culloty arrived at Maryland Shock Trauma Center was it determined that the 16-year-old player had suffered a concussion.

Concussions make it even more difficult. Most experts agree that lacrosse and soccer concussions are increasing, and those sports have joined football as contact sports in which head injuries are more common.

Some leagues - such as the Maryland Interscholastic Athletic Association of private schools - do require a trainer for each school.

"We have probably the most advanced trainers program in the state," said Rick Diggs, the MIAA's executive director.

Athletic trainers become certified through an extensive process. They must first gain a bachelor's degree in athletic training. Then they must pass a competencies checklist and finally pass an exam from the board of certification with the National Athletic Trainers' Association.

Those qualifications give them a decided advantage over coaches in recognizing and treating injuries.

Bob Wade, the coordinator of athletics for Baltimore City public schools, has waged a long and unsuccessful campaign to get athletic trainers for his schools. He hires off-duty emergency medical technicians (EMTs) or members of the Baltimore City Fire Department for coverage of the city's football games. He agrees with Reed about the dangers involved.

"I'm very frustrated," Wade said. "I think our student-athletes deserve better. I think it's a catastrophe waiting to happen. We're addressing football, but we don't have proper coverage for other sports like lacrosse and soccer."

`Gladiator mentality'

Randallstown football coach Albert Howard says without medical personnel to say no, "that whole gladiator mentality," in which injured players often try to mask their pain and return to the field, takes over.

That happened last season when Randallstown wide receiver Darrell Bryant was dazed on a first-quarter hit against Hereford and tried to return. Randallstown had a physician on the sideline and Bryant was not allowed back in a game the Rams lost.

"The adrenaline's flowing and the kids don't want to feel like they let the coaches down," Howard said. "If a kid sustained an injury to the head, he's not able to coherently make a decision like that. I'm not going to put my job, or my family, in jeopardy because a kid wants to go back in and play."

Sometimes players with concussions are allowed to play on, though. Dr. Gerard A. Gioia, who leads a concussion research initiative in Rockville and is director of the Pediatric Neuropsychology Program at Children's National Medical Center in Washington, acknowledged one such case, although he declined to identify the school or player.

"We have seen situations where a high school quarterback clearly had a concussion and nobody was there with appropriate credentials to recognize it on the field," he said. "The kid played through the second play and was injured further.

"The parents were in the stands and sensed something didn't seem right. He was injured a third time and stumbled off the field. ... It was a lack of recognition until the parents said something was wrong with their kid."

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