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The Association Between Access to Athletic Trainers and Emergency Medical Services Activations for Sport-Related
Rebecca M Hirschhorn1, Robert A Huggins2, Zachary Y Kerr3
1School of Kinesiology, Louisiana State University, rhirschhorn@lsu.edu, @rebeccmh.
Context:
Having athletic trainers (ATs) employed at secondary schools is associated with improved preparedness for sport-related emergencies. Utilization of emergency medical services (EMS) with different access to athletic training services remains unknown.
Objective:
Compare the incidence of EMS activations for sport-related injuries between zip-codes with varying access to athletic training services.
Design:
Descriptive epidemiology study.
Setting:
Data were obtained from the National EMS Information System and the Athletic Training Location and Services Project.
Patients Or Other Participants:
Zip-codes where 9-1-1 EMS activations for sport-related injuries among individuals 13-18 years old occurred.
Main Outcome Measure(S):
Incidence of EMS activations, athletic training service level (NONE, PART, FULL), athletic training employment model (independent contractor, IC; medical or university facility, MUF; school district, SD; mixed employment models, MIX) for each zip-code.
Results:
There were 2.8±3.5 EMS activations per zip-code (range 1-81, n=4,923). Among zip-codes where at least 1 AT was employed (n=2,228), 3.73% (n=83) were IC, 30.83% (n=687) were MIX, 27.24% (n=607) were SD, and 38.20% (n=851) were MUF. Compared to SD, MUF had a 10.8% lower incidence of EMS activations (95%CI: 0.817, 0.974, p=0.010). IC (IRR: 0.920, 95%CI: 0.758, 1.118, p=0.403) and MIX (IRR: 0.996, 95% CI: 0.909, 1.091, p=0.932) were not significantly different from SD. Service level was calculated for 3,834 zip-codes, with 19.5% (n=746) NONE, 46.2% (n=1,771) PART, and 34.4% (n=1,317) FULL. Compared to NONE, FULL (IRR: 1.416, 95%CI: 1.308, 1.532, p<0.001) and PART (IRR: 1.368, 95%CI: 1.268, 1.476, p<0.001) had higher incidences of EMS activations.
Conclusions:
Local access to athletic training services is associated with an increased utilization of EMS for sport-related injuries among secondary school aged individuals, potentially indicative of improved identification and triage of sport-related emergencies the area. The difference in EMS utilization between employment models may represent the presence of different policies and procedures for sport-related emergencies.
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