title: Prevalence and characteristics of general and football-specific emergency medical service activations by high school and collegiate certified athletic trainers: a national study.
abstract: OBJECTIVE
  To describe frequency and characteristics of emergency medical services (EMS) activations by certified athletic trainers (ATs) and effects of pre-season planning meetings on interactions between ATs and EMS both generally and specifically during football head/neck emergencies.
  
  
  METHODS
  Retrospective cross-sectional survey.
  
  
  METHODS
  2009 Web-based survey.
  
  
  METHODS
  Athletic trainers (n = 1884; participation rate, 28%) in high school and collegiate settings.
  
  
  METHODS
  Athletic trainer work setting, AT demographics, history of pre-season planning meetings.
  
  
  METHODS
  Proportions and 95% confidence intervals (CIs) estimated the prevalence of EMS activation, planning meetings, and characteristics of AT-EMS interactions (eg, episodes of AT-perceived inappropriate care and on-field disagreements). Chi square tests tested differences (P < 0.05) in proportions. Associations (odds ratio = OR and 95% CI) between work setting, demographics, preseason meetings and fall 2008 1) episodes of AT-perceived inappropriate care, and 2) on-field disagreements were assessed using multivariate logistic regression.
  
  
  RESULTS
  High school ATs activated EMS more frequently than collegiate ATs (eg, fall 2008 EMS activation for football injury, 59.9% vs 27.5%; P < 0.01) and reported fewer pre-season planning meetings (eg, met with EMS to practice, 38.1% vs 55.8%; P < 0.01). During the Fall 2008 football season, high school ATs perceived more episodes of inappropriate care (10.4% vs 3.9%; P < 0.01) and on-field disagreements (5.4 vs 2.2%; P < 0.01) than collegiate ATs. High school work setting was independently associated with episodes of AT-perceived inappropriate care (adjusted OR = 2.76; 95% CI, 1.65-4.62) and on-field disagreements (adjusted OR = 2.33; 95% CI, 1.17-4.64).
  
  
  CONCLUSIONS
  Athletic trainer-EMS interactions are common and sometimes involve AT-perceived episodes of inappropriate care and on-field disagreements between emergency care providers.
authors.affiliation: NH Musculoskeletal Institute, Manchester, New Hampshire 03101, USA. laura@nhmi.net
authors.forename: Laura C
authors.initials: LC
authors.lastname: Decoster
authors.forename: Erik E
authors.initials: EE
authors.lastname: Swartz
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Cappaert
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Hootman
mesh_terms: D000328:Adult; D002568:Certification; D006259:Craniocerebral Trauma / Q000453:epidemiology* / Q000628:therapy; D003430:Cross-Sectional Studies; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D005538:Football / Q000293:injuries*; D019538:Health Care Surveys / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000453:epidemiology* / Q000628:therapy; D015995:Prevalence; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology