Cardiac conditions caused 47% of 34 youth sport-related deaths from 2010-2014, prompting best-practice recommendations for emergency action plans, sudden cardiac arrest, and heat stroke management.
This task force document establishes best-practice recommendations for emergency health and safety in youth sports leagues to prevent catastrophic injuries and sudden death.
Recent data from the Sports however, few to no data regarding sudden death during participation in youth sports are available. Unpublished data on 34 youth (<14 years of age) sport-related deaths from 2010 through 2014 collected by the Korey Stringer Institute3 at the University of Connecticut demonstrated that 24% of these deaths (n = 8) occurred during participation in youth sport leagues. Cardiac conditions, which are traditionally the most commonly identified cause of death at all levels of sport, were responsible for 47% (n = 16). From 2000 through 2014, baseball (n = 5), soccer (n = 4), football (n = 3), basketball (n = 2), and lacrosse (n = 1) accounted for all deaths in youth athletes <12 years of age. Given the large youth sport participation rates1 and scarcity of published data other than emergency room–documented sudden deaths in youth sports,2 it is imperative to improve sport safety policies and strive toward best practices. Catastrophic injury is an obvious threat to this population. With increased awareness of the potential causes of death and implementation of preventive mechanisms, member organizations can improve the health and safety of these young athletes.Each NGB functions independently; therefore, implementing best-practice health and safety policies at the youth sport level is challenging. Currently, no single entity oversees governance for all youth sports. As a result, uniformity in safety policies and procedures across organizations is lacking. Governing bodies often encounter difficulty enforcing current best-practice policies and may only be able to recommend or create guidelines rather than mandate change. Potential barriers NGBs encounter when attempting to mandate policy include high rates of participation, a wide range of age groups, budgetary restrictions, diverse geographic locations, and a lack of internal administration. These barriers were commonly expressed by youth sport NGB leaders during the 2015 and 2016 Youth Sport Safety Governing Bodies meetings held in New York, New York.4In an effort to improve the emergency health and safety best practices and policies in youth sport, this document was developed to serve as a road map for policy and procedure recommendations. It addresses the most common conditions resulting in sudden death and outlines recommended policies and procedures designed to improve youth sport safety. It serves as a call to action for youth sport NGBs to provide support systems for member organizations and to educate league leaders and their members about the current best practices regarding emergency action plans (EAPs),5–7 sudden cardiac arrest (SCA),7 exertional heat stroke (EHS),8–10 and brain and neck injury protocols.11–13 The document also discusses preexisting medical conditions,14,15 environmental conditions,8,16 and emergency medical care,5 such as the use of athletic training services. These concerns were discussed at the January 21, 2016 Youth Sport Safety Governing Bodies Meeting in New York, New York,4 in an effort to promote positive change and assist with the strategic implementation and advancement of the best health and safety practices in youth sports.Each organization is unique, and therefore each will need to address policy and procedure recommendations differently to ensure successful implementation of best practices. Furthermore, all best-practice policy and procedure recommendations may not be necessary for each sport (eg, a lightning policy for most indoor sports). Many deaths in youth sports are preventable. The goal of this document is to support youth sport NGBs and provide them with the structure and tools to prevent avoidable deaths.The organizations that were invited to and participated in the meetings and endorsed this document are listed in Appendix A. Those organizations that have officially endorsed the document are referred to throughout the document as the Task Force. Other definitions used in this document appear in the Table.The Task Force recommends NGBs implement the following:The Task Force agrees that member organizations shouldThe EAP should be implemented in concert with local emergency medical service (EMS) providers by the member leader (ie, league safety officer, commissioner, or director) within the youth sport organization who oversees safety responsibilities under the direction of the NGB.Important note: These components should be presented in a clear and logical manner (ideally on 1 sheet of paper) with step-by-step directions for the individual(s) at the event or venue with the assistance of the local EMS.The Task Force agrees that member organizations shouldThe Task Force supports recommendations from the American Academy of Family Physicians and American Academy of Pediatrics33 and American Medical Society for Sport Medicine30 as the minimum standards for screening using the comprehensive personal history, family history, and physical examination.Note: Any youth athlete who has collapsed and is unresponsive should be assumed to be in SCA until proven otherwise or another cause of the collapse is identified.Member leaders and member coaches should beThe Task Force agrees that member organizations shouldMember leaders and member coaches should receive education focusing on the prevention, recognition, and management of athletes with brain or neck injury, such asThe return-to-play process may begin once symptoms have resolved (unless otherwise directed by a medical provider) and the athlete is cleared by appropriate medical personnel.Note: As directed by an appropriate medical professional, the athlete should not advance to the next step unless he or she is symptom free at the current step (unless otherwise specified by appropriate medical personnel) and a minimum of 24 hours has elapsed between steps.The Task Force agrees that member organizations shouldSpecific guidelines outlining equipment use, intensity and duration of exercise, rest breaks, hydration, and total practice time, such as those outlined in the heat-acclimatization guidelines for secondary school athletics,55 should be followed.Procedures for proper management of EHS:The Task Force agrees that member organizations shouldThe parents or guardians of all member athletes should be encouraged to complete a form that discloses all known medical conditions. This form should also include a treatment plan for these individuals, consisting of the medications used as well as who will be responsible for ensuring these medications are present during practices and competitions. Furthermore, member organizations should educate parents and guardians on the dangers of not disclosing such conditions.The Task Force agrees that member organizations shouldThe Task Force agrees that member organizations shouldThis document is intended to serve as a call to action for all youth sport NGBs to provide support systems for member organizations through the education of league leaders and their members on the current policy and procedure best practices regarding EAPs, SCA, brain and neck injury, EHS, and other potentially threatening medical conditions (Appendix B). This document also discusses preexisting medical conditions, environmental conditions, and emergency medical care, such as athletic training services. The Task Force recognizes that each organization is unique and, therefore, will need to address policy and procedure recommendations differently to ensure the implementation of best practices. Furthermore, the Task Force recognizes that all best-practice policy and procedure recommendations may not be necessary for each sport (eg, lightning policy for indoor sports). Many of the deaths in youth sports are preventable, and it is the goal of the Task Force to support youth sport NGBs in this mission of prevention.The National Athletic Trainers' Association (NATA) and this Inter-Association Task Force advise individuals, national youth sport governing bodies, staff, organization member leaders, member coaches, and member players to carefully and independently consider each of the recommendations. The information contained in these recommendations is neither exhaustive nor inclusive of all circumstances or individuals. Variables such as institutional human resource guidelines, state or federal statutes, rules, or regulations, as well as regional environmental conditions, may affect the relevance and implementation of these recommendations. The NATA and the Inter-Association Task Force advise their members and others to carefully and independently consider each of the recommendations (including the applicability of some to any particular circumstance or individual). The foregoing statement should not be relied upon as an independent basis for management and care but rather as a resource available to NATA members, national youth sport governing body members, and others. Moreover, no opinion is expressed herein regarding the quality of care that adheres to or differs from NATA's position statements. The NATA and the Inter-Association Task Force reserve the right to rescind or modify their position statements at any time.
Huggins et al. (Tue,) conducted a review in Youth sports safety and sudden death prevention. Emergency health and safety best practices and policies was evaluated. Cardiac conditions caused 47% of 34 youth sport-related deaths from 2010-2014, prompting best-practice recommendations for emergency action plans, sudden cardiac arrest, and heat stroke management.