Emergency Action Planning in Kansas High Schools

Introduction. Current evidence shows a variable rate of emergency action plan (EAP) implementation and a low rate of compliance to EAP guidelines in United States secondary schools. Compliance to emergency action plan recommendations in Kansas high schools is not known. The purpose of this study was to identify the emergency preparedness of public high school athletics in the state of Kansas and identify prevailing characteristics of schools that correlate with decreased compliance of an EAP. Methods. Athletic directors for public high schools in the state of Kansas were asked to participate in a web-based questionnaire that was emailed to each athletic director. The questionnaire identified demographics of the study population, EAP implementation rates, compliance to national EAP guidelines, access to certified medical personnel, and training received by athletics personnel. Descriptive statistics were then compiled and reported. Results. The response rate for the survey was 96% (341/355). A total of 94.1% (320/340) of schools have an EAP, 81.4% (276/339) of schools have an automated external defibrillator (AED) at all athletic venues, and 51.8% (176/340) of schools had an athletic trainer (AT) on staff. Urban schools were significantly more likely than rural schools to have an AT on staff (OR=11.10, 95% CI=[6.42, 19.18], p<0.0001), have an EAP (OR=3.69, 95% CI=[1.05, 13.02], p=0.0303), require additional training for coaches (OR=2.69, 95% CI=[1.42, 5.08], p =0.0017), and have an AED on-site for some events (OR=2.18, 95% CI=[1.24, 3.81], p=0.0057). Conclusions. Most Kansas high schools have an EAP in place and have at least 1 AED. Emergency planning should be improved through venue specific EAPs, access to early defibrillation, and additional training. Rural and low division schools have lower AT staffing and consequently are more significantly impacted by these factors. Rural and low division schools are more significantly impacted than urban and high division schools and this should be taken into account in future improvement strategies

Emergency Action Planning in School-Based Athletics: A Systematic Review

Introduction. A significant number of preventable catastrophic injuries occur in secondary school athletics. Compliance to Emergency Action Plan (EAP) recommendations is not well documented. The purpose of this systematic review was to identify compliance to EAP recommendations, access to an athletic trainer (AT) and automated external defibrillator (AED), and current legislative mandates in school-based athletics. Methods. Electronic databases were searched to identify articles that met criteria for inclusion. Studies in English that focused on adoption, implementation, or compliance with EAPs or other national guidelines pertaining to athlete health were eligible for inclusion. Quality and validity were examined in each article and data were grouped based on outcome measures. Results. Of 12,906 studies, 21 met the criteria for inclusion and full text review. Nine studies demonstrated EAP adoption rates ranging from 55% - 100%. Five studies found that EAPs were rehearsed and reviewed annually in 18.2% - 91.6% of schools that have an EAP. At total of 9.9% of schools were compliant with all 12 National Athletic Trainers Association (NATA) EAP guidelines. A total of 2.5% - 27.5% of schools followed NATA exertional heat illness guidelines and 50% - 81% of schools had access to an Athletic Trainer. In addition, 61% - 94.4% of schools had an AED available at their athletic venues. Four of 51 state high school athletic association member schools were required to meet best practice standards for EAP implementation, 7 of 51 for AED access, 8 of 51 for heat acclimation, and 3 of 51 for concussion management. Conclusions. There was a wide range of EAP adoption and a low rate of compliance to EAP guidelines in U.S. schools. Barriers to EAP adoption and compliance were not well documented and additional research should aim to identify impeding and facilitating factors