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The Commercial Appeal (Memphis, Tennessee)
One of the unfortunate constants in football is that participants die or are seriously injured each year, and statistics show that high school athletes are particularly vulnerable.
According to the National Center for Catastrophic Sport Injury Research, 42 football players at all levels died of direct and indirect causes between 2015 and 2017. Of that total, 30 involved high school players.
Why do those at the high school level die at such alarming rates?
Experts say there are a variety of reasons, ranging from inadequate equipment to the development of the brain to the availability of qualified trainers.
"Unfortunately, some of these deaths are preventable," Kevin Guskiewicz told USA TODAY in 2014, "and when you don't have appropriate medical care out there, you can have players going back to play when they shouldn't."
Guskiewicz is founding director of the Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center at the University of North Carolina.
A certified athletic trainer was not at Coahoma County High School in Mississippi on Friday night when Byhalia High School player Dennis Mitchell collapsed after re-entering the game after absorbing a hit and vomiting on the sidelines. He was later pronounced dead at a hospital.
Deaths result from hits, heat stroke
Not much has changed in terms of the statistics since Guskiewicz's comments four years ago. High school athletes such as Mitchell continue to lead the way in fatalities.
The Catastrophic Sport Injury Research findings divide football fatalities into direct and indirect categories. Direct deaths result directly from injuries sustained during play, while indirect causes include things like heat stroke and cardiac events.
The numbers show that in 2017, the most recent year for which statistics are available, four direct fatalities occurred - two at the high school level and two at the college/university level.
Among indirect deaths, seven of nine were at the high school level and two in college/university competition.
The trend was the same in 2016, when two of three direct deaths and five of nine indirect were among high school players.
In 2015, all seven direct fatalities were among high school players. Seven of 10 indirect deaths were high school athletes.
The National Center for Catastrophic Sport Injury Research has a long list of recommendations to make competition safer for high school players. The complete list of recommendations is available in the organization's annual report for all sports.
Among the recommendations:
Every school should have a certified athletic trainer.
An automatic electronic defibrillator should be available and accessible onsite and staff should be trained in its use.
All personnel associated with sport participation should be cognizant of the safety measures related to physical activity in hot weather.
When a player has shown signs or symptoms of head trauma (such as a change in the athlete's behavior, thinking or physical functioning), the player should receive immediate medical attention from an appropriate medical provider and should not be allowed to return to practice or the game that day.
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