It may be some time before we learn what caused the shocking death of West Orange (Texas) High School quarterback Reggie Garrett during his team's victory on Friday night, but we can be sure of one thing: Most schools are ill-equipped to respond to such a situation during many practices and games because most American high schools lack full-time athletic trainers.
According to a study by the Scripps Howard News Service published Saturday by The Ventura County Star, hardly one-third of U.S. high schools employ a full-time athletic trainer, while most schools cobble together in-practice (and sometimes even in-game) first aid for athletes among part-time athletic trainers, coaches trained in minimal first aid and nurses or EMTs (emergency medical technicians). National Athletic Trainers Association data cited in a piece from The New York Times claims that only 42 percent of American high schools have access to an athletic trainer, but those trainers are not necessarily full-time employees at the school.
Making matters worse, in some states schools are often in violation of regulations requiring them to have athletic trainers present at all games. Here's what an independent observer told The New York Times about the lack of compliance with athletic trainer regulations in Rhode Island:
"Here in Rhode Island we have a state law that an athletic trainer must be at contests, but most schools are in violation," Dr. John P. Sullivan, the University of Rhode Island's sports psychologist, wrote in an e-mail Tuesday. "The risk is real."
The Scripps Howard study findings ring a troubled note just a day after Garrett's shocking death and the troubling passing of 16-year-old Chicaksha (Okla.) High School offensive lineman Kody Turner, who collapsed at a team practice last Tuesday and died Friday morning. It also comes less than two weeks after a freshman in Apopka, Fla., died during an afternoon football practice.
The relevance of Wekiva High School freshman Olivier Louis' death is particularly striking because an overwhelming amount of schools lack adequate training for heat-related conditions among their coaches. The 2008 death of a 15-year-old football player in Kentucky pushed Kentucky state athletic officials into forcing all coaches to take online sports medicine training, but to date Kentucky remains the only state in the entire country to take such measures.
That lack of heat training -- as well as the lack of necessary training for concussion treatment and other major issues -- in turn leads to an array of scattershot diagnoses at schools without full-time athletic trainers. In those schools, students are often sent to the hospital for more minor injures but kept at practice when more serious conditions, like a significant concussion, do occur.
On Friday, Garrett collapsed on the sideline and players assumed that he was suffering a seizure, of which he was rumored to have a history. However, his mother countered those claims on the "Today" show Monday morning, just as the West Orange program announced it was canceling this weekend's game in the aftermath of Garrett's death.
"It's true that schools with trainers are more likely to send serious injuries along to a higher level of care," Fred Mueller, director of the National Center for Catastrophic Sport Injury Research at the University of North Carolina told The Star. "Compared with first-aid-trained coaches or EMT, an athletic trainer is more apt to look at an injury, define it, treat what they can locally."
It's not fair to assume that athletic trainers or medical professionals necessarily could have done anything differently in the death of Garrett, Louis or Turner -- nor Oregon running back Hayward Demison's miraculous recovery from an in-game heart attack or the preseason death of South Carolina running back Brian Colvin, for that matter -- but given the difficulties they all had in receiving the treatment they needed immediately, one wonders what would have happened if a similar case had befallen an athlete competing in a lower-profile fall sport like field hockey, soccer or cross country.
A shortage of funding may drive most schools' decisions to forego athletic trainers, but those savings on the school level often come at the cost of students and their families. Without a trainer on campus, most students have to turn to outside physical therapy to help speed recovery from an injury. In at least one case, the treatment provided by a school's athletic trainer would have cost the families of injured students a whopping $3.7 million via private practice.
"Most parents appreciate what we do for their kids when they're hurt; they appreciate the convenience," Glenbrook South (Ill.) High School trainer Brian Robinson told The Star. "But very few know how much money they're saving."
The question now is whether three deaths and a serious sideline scare in three weeks are a large enough catalyst to encourage more schools and school districts to fund full-time athletic trainers. Parents whose children have been helped immediately by trainers are also stepping forward to testify to how important an athletic trainer was to their child's long-term health. Just ask Beth Mallon, a San Diego mother who told The Star about her son Tommy's serious lacrosse injury during his senior season at Santa Fe Christian:
Mallon's son, Tommy, broke his neck in a collision during his final high school lacrosse game as a senior at Santa Fe Christian in May 2009. He wanted to get up off the field. But athletic trainer Riki Kirchoff wouldn't let him move and called for a backboard.
"That saved his life," said Mallon, whose family has set up an advocacy group for injured athletes. "It maintained the integrity of the fracture and it didn't kill him or paralyze him. There couldn't be better testimony for having athletic trainers in all high schools."