Document Type

Article

Publication Date

5-1-2023

Abstract

Context: Having athletic trainers (ATs) employed at secondary schools is associated with improved preparedness for sport-related emergencies. The use of emergency medical services (EMS) in settings with different access to athletic training services remains unknown. Objective: To compare the incidence of EMS activations for patients with sport-related injuries among zip codes with various levels of 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 911 EMS activations for sport-related injuries among individuals 13 to 18 years old occurred. Main Outcome Measure(s): Incidence of EMS activations, athletic training service level (no ATs employed [NONE], less than full-time employment [PARTIAL], all ATs employed full time [FULL]), and athletic training employment model (independent contractor [IC], medical or university facility [MUF], school district [SD], mixed employment models [MIX]) for each zip code. Results: The EMS activations were 2.8 6 3.6 per zip code (range ¼ 1—81, N ¼ 4923). Among zip codes in which at least 1 AT was employed (n ¼ 2228), 3.73% (n ¼ 83) were IC, 38.20% (n ¼ 851) were MUF, 27.24% (n ¼ 607) were SD, and 30.83% (n ¼ 687) were MIX. Compared with SD, MUF had a 10.8% lower incidence of EMS activations (incidence rate ratio [IRR] ¼ 0.892; 95% CI ¼ 0.817, 0.974; P ¼ .010). The IC (IRR ¼ 0.920; 95% CI ¼ 0.758, 1.118; P ¼ .403) and MIX (IRR ¼ 0.996; 95% CI ¼ 0.909, 1.091; P ¼ .932) employment models were not different from the SD model. Service level was calculated for 3834 zip codes, with 19.5% (n ¼ 746) NONE, 46.2% (n ¼ 1771) PARTIAL, and 34.4% (n ¼ 1317) FULL. Compared with NONE, FULL (IRR ¼ 1.416; 95% CI ¼ 1.308, 1.532; P, .001) and PARTIAL (IRR ¼ 1.368; 95% CI ¼ 1.268, 1.476; P, .001) had higher incidences of EMS activations. Conclusions: Local access to athletic training services was associated with an increased use of EMS for sport-related injuries among secondary school—aged individuals, possibly indicating improved identification and triage of sport-related emergencies in the area. The difference in EMS use among employment models may reflect different policies and procedures for sport-related emergencies.

Publication Source (Journal or Book title)

Journal of Athletic Training

First Page

387

Last Page

392

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