Sep 30, 2008
In his four decades working for the N.C. High School Athletic Association, Charlie Adams can’t remember even one instance of a concussion-related death in this state.
In the last month, there have been two.
“To my knowledge, we haven’t had a concussion [-related death] that we know of, that was reported as one, but the evidence in these two cases is pretty clear,” Adams, the association’s executive director since 1984, said Monday.
Matt Gfeller, a sophomore at Winston-Salem Reynolds, died Aug. 24, two days after a hit he sustained in a game led to cranial bleeding.
Jaquan Waller, a junior at Greenville Rose, died Sept. 20 after having been hit in a game the night before. The state medical examiner’s report ruled Waller died of second-impact syndrome. The report stated that Waller had suffered a mild concussion in practice two days before the game. That, coupled with the second hit, caused his brain to swell.
The deaths are bringing calls for change in how schools fare for athletes.
“There nothing more tragic than losing a student athlete, not only for the family but for the child, the school, the squad, and we want to do everything we can to minimize that,” Adams said. “And I don't think there's any question we need a [certified athletic trainer] at every school.”
Last year, among the estimated 1.8 million football participants in the U.S. in 2007, there were 13 football players who died, including four as a result of on-field incidents, according to the National Center for Catastrophic Sport Injury Research at the University of North Carolina.
In North Carolina alone this year, there have been three deaths. Before Gfeller and Waller, Atlas Fraley, a senior at Chapel Hill, was found unresponsive in his home a few hours after he called 911 complaining of body aches and dehydration following a morning scrimmage.
Concussion-related deaths may be a new to North Carolina, but they come as no surprise to Kevin Guskiewicz, who chairs the Department of Exercise and Sports Science at UNC. In order to prevent future cases, he believes stronger measures must be taken.
“In my opinion, the first step has to be employing certified athletic trainers in every secondary school in the country,” Guskiewicz said.
Guskiewicz said certified athletic trainers are better equipped to spot concussions, which could help prevent more catastrophic injuries.
Rose’s Waller was not treated by a certified athletic trainer. He was seen by an injury management specialist, or first responder, which the state defines as someone certified in first aid and CPR.
To become an athletic trainer, one must hold a degree in sports medicine or athletic training from an accredited program and pass the National Athletic Trainers' Association board exam. The person must also accumulate 25 hours of continuing education per year.
The N.C. Board of Education policy manual states that all high schools must have either a licensed athletic trainer or a first responder on staff, and they can be employed on a full-time or part-time basis. An athletic trainer or first responder is also required to be present at all football practices and games.
In Pitt County, where Waller was a student at Rose High, there is only one certified athletic trainer on staff at its six high schools. Heather Mayo, a Pitt schools spokeswoman, said the system has trouble attracting athletic trainers because they must also be teachers.
“It’s not that we don’t welcome or look for them,” Mayo said. “We’ve found we have one of two options. One, it would be a part-time position, which would only be a few hours a week, which doesn’t amount to much money. The other option would be full-time. In order for us to give full-time, they have to be a teacher as well. We just don’t have a full-time athletic position.”
Jim Bazluki, a Cary-based certified athletic trainer for more than 25 years who has worked on the university and high school levels, adamantly disagrees that schools cannot find athletic trainers or afford to pay them.
“It’s that the schools don’t put a priority on hiring licensed athletic trainers,” said Bazluki. “If you look at each of those independently, if they don’t have a position, if the head football coach left, do you think the new person they hire is going to have the exact same teaching credentials as the one who left? They value and want that particular person and the skills they bring to the table as a coach. They won’t use that same criteria if they lose an athletic trainer. They won’t find a position. Any school that wanted to hire a new person for any purpose, they can find the money if it was a priority to them.”
Bazluki also notes that no other in-school health care provider, such as a school nurse or speech pathologist, is required to teach, too.
“Why do we require the one to do both?” Bazluki said. “If the schools were serious about it, why do [students] have to go to college and earn two degrees to get one job? That’s why there’s a shortage. No one with two degrees is going to work for a teacher’s salary.”
In Wake County, that isn’t a problem.
Bobby Guthrie, Wake County Schools’ athletic director, said having certified athletic trainers available to the nearly 15,000 student-athletes in the school system is vital.
“We’ve got an awful lot of athletes out there,” Guthrie said. “We’ve got 600 to 800 students per high school out there playing over the course of the year. We want to make sure we’re putting the best we can out there to take care of them. To me it’s as important as anything, the safety of the athlete.”
Guthrie said only one of the system’s 18 high schools does not have a certified athletic trainer on staff. And in that instance, at Sanderson High, Guthrie said that person is working toward licensure. Some Wake schools have two athletic trainers on staff.
But Guthrie noted that not every school system is “blessed” like Wake County.
Bazluki said the current state mandate allows schools to place unqualified people in a position where their decisions and diagnoses have life-and-death implications. If there’s going to be a change, it must come from the top.
“It’s going to require state funding because every school acts like they’re broke. They’re not,” Bazluki said. “The fix is going to have to be, across the state, hire athletic trainers in non-teaching roles. … [Waller’s case] is 100 percent proof of what happens when you have someone who doesn’t know how to deal with the injury.”