Danger on the football field: Many states are still failing high school athletes

My son's high school football team ended its season with a 2-8 record, finishing second-to-last in its Southern California league. I'm sure he would have liked his football career to end differently. But I was simply glad to see it come to a close.

As any parent of an athlete knows, playing sports carries certain risks. In the case of football, some of those risks have gotten prominent coverage over the last few years, and rightly so. Tackle football dominates at the high school level, with more than 1 million boys playing the sport and more than 14,000 schools around the country fielding teams. Yet despite many high-profile cases of injury, too many schools still lack critical safety policies to help keep high school athletes from being seriously injured. Even though football may be "as safe as it ever has been," that doesn't mean it's actually safe.

My son had never played tackle prior to high school. As he worked his way up from the bottom of the depth charts his freshman year to become a starting outside linebacker as a senior, I noted with growing unease the continued reports on the long-term risks of tackle football — not just from concussions, but from subconcussive hits as well. The more I learned, the more I worried.

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The lowest point came last fall, when one of my son's teammates nearly died on the sidelines after his heart stopped. At the time, California didn't require on-site automated external defibrillators (AEDs) at schools; instead, the entire stadium watched an EMT do chest compressions before the ambulance sped away, sirens blaring.

The boy was lucky: He made a complete recovery and even returned to the field later that season. But situations like his often have far-worse outcomes. One recent study found that more than 50 high school athletes died from sudden cardiac arrest during the two-year period studied, with football and basketball being the two most deadly sports. In fact, sudden cardiac arrest is the leading cause of all sport-related deaths. But right now, the majority of states still don't require schools to have on-site AEDs at athletic events, even though they literally can mean the difference between life and death.

There were other scares, too, during my son's high school football career: His freshman year, the opposing team's (certified) trainer had to step in to treat one of our varsity players, who had collapsed and was unconscious, after realizing our uncertified trainer (who's since retired) wasn't doing so. According to coverage of the incident, our trainer apparently thought the player was merely showing "flu-like symptoms," when in fact he'd suffered a brain bleed that required a five-hour surgery.

Truly, both boys were lucky to have survived. These instances, already life-threatening, were made even more dangerous by an appalling lack of safeguards.

Back in 2013, a task force representing leading medical and sports-safety groups (including the American Academy of Pediatrics, American College of Emergency Physicians, and the National Athletic Trainers' Association) published a list of recommendations to help prevent sudden death in high school athletes. (Having AEDs was one of them.) But unfortunately, there isn't yet a single state that's fully making the grade. Since 2017, the Korey Stringer Institute — named for the Minnesota Vikings player who died of exertional heat stroke in 2001 — has regularly assessed all 50 states and the District of Columbia on whether they've implemented the identified best practices to help keep high school athletes from dying or being seriously injured. In KSI's just-released rankings, New Jersey leads the pack at 83 percent. When the state first made the top of the list last year, Samantha Scarneo, KSI's vice president of sport safety, noted that New Jersey isn't "sitting back and waiting for a kid to die to make these changes."

But in far too many cases, it takes tragedies to spur action.

It took the near-death of Zackery Lystedt, who ended up in a coma after sustaining two concussions during a 2006 middle school football game, to spur the first concussion law in Washington State in 2009. Since then, similar laws have been passed in all 50 states, resulting in a marked drop in the number of repeat concussions.

More recently, last year's death of University of Maryland football player Jordan McNair from exertional heat stroke made nationwide headlines, drawing attention to the many shortcomings in how the university failed to recognize or respond until it was too late.

And in Florida, where, since 2010, more high school athletes have died from exertional heat stroke than in any other state, Laurie Giordano has been pushing for mandatory cooling tubs since her 16-year-old son, Zach Martin-Polsenberg, died from heat stroke after a summer football practice in 2017. But Florida has yet to require them.

What makes deaths like McNair's and Martin-Polsenberg's even more tragic is that exertional heat stroke is 100 percent survivable if it's promptly treated. And yet, according to the KSI's most recent rankings, only 13 states require high schools to have on-site cold-water immersion tubs, which are the recommended best way to cool athletes who are dangerously overheated. At the college level, the National Collegiate Athletics Association recently issued recommendations that include treating exertional heat stroke with full-body cold-water immersion, but these are not requirements.

My son was lucky: He finished out his four years of football with just a few stitches on his chin. But I hope — for the sake of the nearly 8 million teens in the nation who participate in high school sports, including more than a million football players who will take to the field this fall — that we won't have to wait for yet another tragedy to bring about the changes our kids deserve.