Epidemiology of Injuries Requiring Emergency Transport Among Collegiate and High School Student-Athletes

J Athl Train. 2018 Sep;53(9):906-914. doi: 10.4085/1062-6050-340-17. Epub 2018 Oct 4.


Context:: Data regarding the epidemiology of emergency-transport incidents (ETIs) of patients with sport-related injuries are lacking. Understanding the use of emergency services by athletic trainers can help improve emergency preparedness and prehospital care for injured student-athletes.

Objective:: To determine the frequencies and types of ETIs resulting from athletic participation.

Design:: Descriptive epidemiology study.

Setting:: Participating colleges and high schools during 2009-2010 to 2014-2015 and 2011-2012 to 2013-2014, respectively.

Patients or other participants:: Student-athletes in 23 high school and 25 intercollegiate sports.

Main outcome measure(s):: Data on injuries requiring emergency transport were collected by each team's athletic trainer via their respective online injury-tracking software. Athletic trainers also collected data on athlete-exposures (AEs). Emergency-transport incident frequencies and injury rates per 10 000 AEs with 95% confidence intervals (CIs) were reported. For each ETI, the sport, body part, injury mechanism, and final diagnosis were recorded.

Results:: A total of 339 and 146 ETIs were reported in collegiate and high school players, respectively. Collegiate women's ice hockey had the highest ETI rate (1.28/10 000 AEs; 95% CI = 0.71, 1.86). In high school, football had the highest rate at 0.80 per 10 000 AEs (95% CI = 0.64, 0.97). Athletes with head or face injuries required the most transports in college (n = 71, 20.9%) and high school (n = 33, 22.6%) across all sports. Strains (n = 50, 14.7%) and fractures (n = 35, 24.0%) were the leading diagnoses for patients undergoing transport in college and high school, respectively.

Conclusions:: Athletic trainers should maintain a high level of emergency preparedness when working with sports that have high rates and numbers of ETIs. Athletes with injuries to the head/face required the most frequent transport across competition levels. Athletic trainers should have the appropriate equipment and protocols in place to handle these patients. Future researchers should examine the differences between field and hospital diagnoses to help improve prehospital care and decrease the likelihood of unnecessary emergency transports.

Keywords: concussions; football; fractures; hockey; incidents; prehospital care; sports; strains.

MeSH terms

  • Adolescent
  • Athletes
  • Athletic Injuries / epidemiology*
  • Civil Defense
  • Craniocerebral Trauma / epidemiology
  • Emergency Medical Services / statistics & numerical data*
  • Female
  • Football / injuries
  • Fractures, Bone / epidemiology
  • Hockey / injuries
  • Humans
  • Incidence
  • Male
  • Schools
  • Students
  • Transportation / statistics & numerical data*
  • United States / epidemiology
  • Universities
  • Young Adult