A full time Athletic Trainer at every public high school in Hillsborough County

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Currently there is no policy in Hillsborough County that regulates or mandates Athletic Trainers at high schools. This petition is being created in memory, honor and on behalf of Hezekiah B. Walters.

Hezekiah was a 14 year old boy going into his freshman year at Middleton High School, in Tampa, FL. About 30 minutes into attending football conditioning, it is reported that Hezekiah began to vomit, seizure, loss consciousness and became unresponsive. According to multiple reports, a bystander called 911 while coaches began CPR. Upon arrival of paramedics, Hezekiah was given multiple doses of epinepherine and was shocked multiple times with no result. He was transported to St Joe's hospital where he had no pulse or heart activity so more advanced cardiac support was attempted but he was declared dead a few hours later. Reports have said that Hezekiah's body temperature was recorded at 102*F once at the hospital. We do not know how this temperature was taken, but if his temperature was taken anyway except rectally, his actually body temperature was much higher. This is why when athletic trainers expect heat stroke, there have been taught to use a rectal thermometer to record core body temperature as part of the gold standard of care, which we will discuss later.

In the most recent report from the National Center for Catastrophic Sport Injury Research at UNC Chapel Hill, from July 1, 2016 to June 30, 2017 there was a total of 86 catastrophic injuries/illnesses among high school and college organized sport participants. Of the 86, 75 of these events were due to, or occurred during, sport-related activity. 56 of the sport-related catastrophic events (n=75), were at the high school level (75%, n=56). Of the 56 catastrophic injuries at the high school level, 18 of them resulted in death. Of the 18 deaths, 16 were the result of an indirect cause; meaning that death was caused by systemic failure as a result of exertion (exertion sickling, SCA, etc.) while participating in sports; or by a complication that was secondary to a non-fatal injury.

Tampa is now part of these statistics. Forever. If this tragedy was a result of heat stroke, it could have and should have been completed avoided. Hezekiah Walters should have immediately been placed in an ice bath and had his core temperature monitored. He should not have been allowed to have been transported to a hospital until his core temperature dropped to 102* F. This is the gold standard of care for Exertional Heat Illness. If this gold standard was followed, there is a 100% that he would have survived.

If this tragedy was a result of a cardiac issue, his chances of survival were never going to be great. But, if CPR was administered immediately and properly, his chance of survival would have been greater. If an AED was used, his chances of survival would have again been greater. In regards to sudden cardiac arrest, for ever 1 minute that passes without being shocked by an AED, there is a 10% less chance of survival. There is no mention of if Hezekiah’s vitals (pulse, respiratory rate, blood pressure and core temp) were checked. There is no mention of if coaches had access to or used of an AED before paramedics arrived (approximately 7 minutes after he collapsed). The only action we know took place was that 911 was immediately called. So if there was no aed use and an average response time of 7 minutes for an ambulance… Hezekiah did not stand a chance. 

While an official cause of death has not been released, I will state this fact. Heat stroke is in part categorized by the dysfunction of the central nervous system; aka vomiting, seizure, loss of consciousness, etc. Of those three signs that Hezekiah had, two of them are not related to cardiac arrest. Cardiac arrest does not cause vomiting or seizures. So in my professional opinion- as a certified and licensed athletic as well as a professor at The University of Tampa, Hezekiah was suffering from a form of Exertional Heat Illness, most likely Heat Stroke.

Yes coaches have to take some classes every year that add up to a couple hours of education. This is to prepare them to help out in this situation. The key word here, is “help.” Athletic Trainers spend a minimum of 4 years at an accredited collegiate program, to prepare for events like this. They then have to pass a national certification exam to become certified. In Florida, these certified athletic trainers also have to become licensed. Athletic trainers have a legal duty to use sound judgement and provide appropriate and timely care for their athletes. They are required to not only act in the event of a medical emergency but also know what to do in that situation. The coaches are the helpers to the athletic trainer for emergencies.

We educate our teachers on what to do in the event of an active shooter, but we still hire resource officers to be on campus. Why? Because we don’t expect our teachers to actually be able to, or willing to, stop a shooter. So why do we expect our coaches to be able to determine what is a life threatening injury and how to respond to it? Even beyond this, how can we expect coaches to be able to determine if a player that just rolled his ankle, is safely able to return to play? Or if a kid just tore his acl? Or a fractured rib and has a pneumothorax? Or if a kid has a concussion? We can’t expect them to know any of this because they don’t have the proper education or training. This is a job specifically for Athletic Trainers.

Again. If Hezekiah died from heat stroke and the gold standard of care was not followed, he was allowed to die. It is well known that heat stroke has a 100% survival rate if the gold standard is followed. So if the only thing that was done for him was call 911, perform cpr, give epinepherine, shock him almost 10 minutes later and then transport him to a hospital, he was allowed to die. We allowed Hezekiah B. Walter to die. If he died from sudden cardiac arrest or some heart abnormality, his chances of surviving were never great; but if the proper protocol was followed, he would have had a much better chance of surviving.

I implore you to please mandate that every high school in Hillsborough County, with athletics, have a full time athletic trainer. I say full time because according to Stanford Children’s Health, the majority (62%) of sport-related injuries occur during practice/conditioning. There are 27 public high schools in Hillsborough County. According to the ATLAS project, put out by the Korey Stringer Institute, only 6 of these schools have a full time athletic trainer. There are 9 schools that only have a part time athletic trainer. Leaving us with 12 high schools with no medical coverage for athletics. Using the median salary of an athletic trainer in Florida as a guide, it would cost $1,134,000 to provide a full time athletic trainer at every public high school. But since this is not mandated, because the last time this issue was brought up the county “couldn’t afford it” the county has decided that the life of a child is worth $1,134,000. 

We may never know if Hezekiah’s death could have been avoided if an athletic trainer was present. But we do know that his chances of living would have been much greater, if there was. And I’m sure Hezekiah’s family, friends and loved ones would have had some sort of closure, knowing that every possible measure was taken to help him live. But right now, that is not the case. There is no closure. There could have been a medical professional onsite at the tragic moment in time. But there wasn't. Nothing has been done to mandate, provide or ensure that the most qualified professional, an athletic trainer, was there to tend to Hezekiah in his time of need. So there will now always be that question of "what if?" 

Do not let another child go unattended without an athletic trainer. Do not let another child die without giving him or her every possible chance to survive. Don't let there be another "what if?" Put a full time athletic trainer at every public high school.