Certified Athletic Trainers: Your Partners in the Field

Certified athletic trainers represent a skilled profession that’s been heavily relied upon for the last three decades to handle emergencies at professional, recreational and youth athletic events.

A better understanding of their scope and skill-set could mean the difference between taking the last ambulance off the road for a suspected ankle fracture vs. relying on an expert in the field for proper acute assessments and treatment decision-making. Whether it’s a suspected cervical spine fracture, concussion or a weather-related event, athletic trainers have the clinical education and practical expertise to handle acute emergencies and determine whether further action by an EMS crew is necessary.

New Research Looks at EMS Utilization

Does having a certified athletic trainer at secondary school sporting events result in improved preparedness for sport-related emergencies? How might that affect EMS utilization?

A new study in the Journal of Athletic Training compared the incidence of EMS activations for sport-related injuries between zip codes with varying access to athletic training services. Authors examined NEMSIS data and learned that having a certified athletic trainer on site resulted in increased EMS utilization for injuries and emergencies.

The study concluded that “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.”

Lead author Rebecca Hirschhorn, PhD, ATC, NRAEMT, CSCS, School of Kinesiology, Louisiana State University, is a passionate advocate for the profession of athletic training, yet holds a unique understanding of EMS as an advanced EMT.

“Something I’ve always valued is demonstrating the value of athletic training because I think pretty much anyone in any occupation and any physical activity in a small population can benefit from having an athletic trainer there,” Hirschhorn explained. “And that's something I believe in very strongly since going to school for athletic training. But I also love the EMS aspect of it. After I became an EMT I started noticing where a lot of the differences were. So it's really beneficial for me to have an understanding of the EMS side of it. That’s one of the strengths of having that experience and that credential brings to me because I do understand how EMS operations work and where all of the data comes from.”

This unique perspective fuels Hirschhorn to teach others about the values of both professions, how they differ, and how certified athletic trainers can ease the burden of overloaded EMS systems by handling acute emergencies at sporting events.

“We are there when it happens and are able to do our own triage,” says Hirschhorn. “Is this something where we can safely remove them from the field for further orthopedic evaluation or do we need to splint and transport them?”

What They Do

Athletic trainers have a lengthy educational background that not only involves an undergraduate degree, but also a master’s degree and a board of certification exam.

“In 1990 the American Medical Association recognized athletic trainers as allied health care professionals,” said Hirschhorn. “This is a huge step from people in the past saying [they are] glorified people-takers. We are actual health care professionals and our education supports that as well.”

Hirschhorn is currently teaching her third semester at LSU’s graduate program in athletic training and sees a promising future for their current cohort of athletic trainers.

“Our first master's cohort graduate this upcoming spring—typically in the past and the same for the students here who went through the undergrad program—they can go anywhere they want,” Hirschhorn said.

She also identified that there are many nontraditional settings for athletic trainers, such as working in the performing arts, ROTC, serving in the military, industrial settings, and for companies such as Amazon—many of which have an athletic trainer position. Some fire and EMS districts are also hiring athletic trainers for their staff.

Says Hirschhorn, “Working inside EMS agencies for help with injuries is a benefit and working toward prevention is a goal of an athletic trainer.”

Furthermore, EMS, police, and fire agencies that employ athletic trainers could be seen as investing in their employees, since first responders are particularly susceptible to musculoskeletal injuries that can range from a few days off work to a career-ending catastrophe.

Educating Peers and the Public

For years, sporting events in less-populated areas have relied on coaches, volunteers or parents in the stands for medical management of injuries and medical events. Certified athletic trainers are able to manage the situation, make medical decisions and determine return-to-play criteria. More ATs are needed at practices and games to keep athletes (and bystanders) safe, stresses Hirschhorn.

“There are a lot of barriers to having access to an athletic trainer,” she says. “A lot of it tends to be financial—who’s going to pay for the athletic trainer to be there?”

Hirschhorn has become a valuable resource for fellow EMTs and paramedics who may not fully understand what ATs do and what they know. Just as important, Hirschhorn educates her fellow athletic trainers regarding the role of EMS in a medical emergency and how the strengths of the two professions can complement each other. Managing resources can mean more appropriate responses to acute sports injuries on the field and other community 9-1-1 emergencies, she says.

Hirschhorn’s passion for her profession is contagious and her goals for the future are inspiring as she continues to advocate for athletic trainers.

“I hope it gives people information to 1) educate them and also 2) be used to advocate for appropriate medical coverage,” she said. “A lot is focused on high school settings and collegiate settings but there are other people who are also participating in athletics. There are other settings that can benefit from an athletic trainer. My hope is that this can be used to help advocate for and be used to support best practices related to sport-related emergencies.”

Hirschhorn’s study, “The Association Between Access to Athletic Trainers and Emergency Medical Services Activations for Sport-Related Injuries,” was published online ahead of print in the October 2022 issue of the Journal of Athletic Training. 

The full study is open-access and accessible here.

Leah Sobon is a freelance writer and paramedic at the Region of Peel, Ontario, Canada.