Olympia Robert P, Dixon Trevor, Brady Jodi, Avner Jeffrey R
Department of Emergency Medicine, Newark Beth Israel Medical Center, Saint Barnabas Health Care System, Newark, NJ, USA.
Pediatr Emerg Care. 2007 Oct;23(10):703-8. doi: 10.1097/PEC.0b013e318155adfc.
To use nationally published guidelines to examine the preparedness of schools in the United States to respond to emergencies associated with school-based athletics.
A questionnaire, mailed to 1000 randomly selected members of the National Athletic Trainers' Association, included questions on the clinical background of the athletic trainer, the demographic features of their school, the preparedness of their school to manage life-threatening athletic emergencies, the presence of preventative measures to avoid potential sport-related emergencies, and the immediate availability of emergency equipment.
Of the 944 questionnaires delivered, 643 (68%) were returned; of these, 521 (81%) were eligible for analysis (55% usable response rate). Seventy percent (95% confidence interval [CI], 66-74) of schools have a Written Emergency Plan (WEP), although 36% (95% CI, 30-40) of schools with a WEP do not practice the plan. Thirty-four percent (95% CI, 30-38) of schools have an athletic trainer present during all athletic events. Sports previously noted to have higher rates of fatalities/injuries based on published literature, such as ice hockey and gymnastics, had, according to our data, less coverage by athletic trainers compared with other sports with lower rates of fatalities/injuries. Athletic trainers reported the immediate availability of the following during athletic events: cervical spine collar (62%, 95% CI, 58-66), automatic electronic defibrillator (61%, 95% CI, 57-65), epinephrine autoinjector (37%, 95% CI, 33-41), bronchodilator metered-dose inhaler (36%, 95% CI, 32-40).
Although schools are in compliance with many of the recommendations for school-based athletic emergency preparedness, specific areas for improvement include practicing the WEP several times a year, linking all areas of the school directly with emergency medical services, increasing the presence of athletic trainers at athletic events (especially sports with a higher rate of fatalities/injuries), regulating the care of and inspection of school facilities and fields, requiring the use of safety equipment (such as mouth guards and protective eye equipment), and increasing the availability of automatic electronic defibrillator in schools.
运用全国发布的指南来审视美国学校应对与校内体育活动相关紧急情况的准备情况。
向随机抽取的1000名国家运动训练师协会成员邮寄一份问卷，内容包括运动训练师的临床背景、所在学校的人口统计学特征、学校处理危及生命的体育紧急情况的准备情况、避免潜在运动相关紧急情况的预防措施的存在情况以及应急设备的即时可用性。
在送达的944份问卷中，643份（68%）被退回；其中，521份（81%）符合分析条件（有效回复率为55%）。70%（95%置信区间[CI]，66 - 74）的学校有书面应急计划（WEP），不过有36%（95% CI，30 - 40）有WEP的学校并未演练该计划。34%（95% CI，30 - 38）的学校在所有体育赛事期间都有运动训练师在场。根据已发表文献，此前指出死亡率/受伤率较高的运动项目，如冰球和体操，根据我们的数据，与死亡率/受伤率较低的其他运动相比，运动训练师的覆盖范围更小。运动训练师报告在体育赛事期间可即时获取以下物品：颈椎固定器（62%，95% CI，58 - 66）、自动体外除颤器（61%，95% CI，57 - 65）、肾上腺素自动注射器（37%，95% CI，33 - 41）、支气管扩张剂定量吸入器（36%，95% CI，32 - 40）。
尽管学校在很多校内体育应急准备建议方面符合要求，但具体需要改进的方面包括每年多次演练书面应急计划、将学校所有区域与紧急医疗服务直接联系起来、增加体育赛事期间运动训练师的在场人数（尤其是死亡率/受伤率较高的运动项目）、规范学校设施和场地的维护与检查、要求使用安全设备（如护齿器和护眼设备）以及增加学校自动体外除颤器的可用性。
