Pre-Event Medical Meeting With, Without Medical Professionals

High school athletic events involve risk. Any activity that involves contact, speed and environmental conditions has a potential for injury and that injury could be severe. It is important that schools manage that risk with preparation. A brief pre-game/pre-event medical time-out meeting with important stakeholders provides a simple and effective step. These types of pre-event meetings are already being held at the college and professional levels.

These meetings should occur before warm-ups or immediately before the contest. Participants should include game officials and team representatives. Athletic trainers or physicians should attend when present. Coaches and officials should conduct the meeting when medical professionals are absent.

The meeting doesn’t need to be long. Everything that needs to be communicated can be accomplished in about two minutes. The discussion should focus on medical readiness and emergency response. The goal of the meeting is to provide clarity before the first whistle on everything that may occur in the event of a serious injury. Preparation reduces confusion ikf and when an event occurs.

Purpose of the Medical Time-Out
A pre-event medical meeting establishes a shared emergency plan. The discussion identifies key personnel, confirms the availability and location of important medical equipment, and defines communication steps during an emergency.

Athletic events move quickly, and, more often than not, injuries occur without warning. A coordinated response protects athletes and reduces liability exposure.

A school or an individual that follows a clear process demonstrates reasonable care which is important because attorneys and the courts often examine preparation after an incident to determine if it was reasonable and prudent. A documented and consistent pre-game meeting shows that safety planning occurred.

While it seems reasonable to think that common sense supports this practice, leaders should never assume that everyone understands the emergency plan. A short, clear conversation confirms that understanding as proper communication helps to ensure a better result.

When Medical Personnel Are Present
Athletic trainers or physicians often serve as the lead medical authority for a contest. The medical professional directs the discussion of injury response. Officials and coaches should listen and confirm their roles.

The athletic trainer should identify the treatment location. The AT identifies the location of emergency equipment and should also confirm the availability of an automated external defibrillator (AED).

The athletic trainer should also confirm access routes for emergency vehicles as emergency responders need a clear entry point. Gates, doors or barriers must remain unlocked.

The group should confirm the following information:

• Location of the AED

• Location of the athletic trainer or physician during play

• Emergency vehicle access point

• Communication method with emergency services

• Severe weather procedures

Officials should also identify the signal used to stop play for a medical emergency. A loud whistle and crossed arms above the head remain common signals for officials to use.

The meeting should always end with one question: Does anyone have additional safety concerns? Clear communication at this moment prevents hesitation later.

When No Medical Professional Is Present
Many high school contests occur without an athletic trainer or physician. Rural districts and smaller schools often face this situation. Officials and coaches must still address emergency preparation.

The home school representative should lead the discussion. The representative is usually the athletic director, site manager, or head coach.

The meeting should identify the person responsible for emergency coordination. One person should call emergency medical services (EMS), while another person retrieves the AED.

Schools should never assume that an AED is nearby without confirming its location. The group must identify the device before the game begins.

The discussion should confirm the following items:

• Exact AED location

• Person assigned to retrieve the AED

• Person assigned to call 911

• Emergency vehicle entry point

• Designated area for medical care

Officials should also confirm their role during an emergency. Officials control the contest and can stop play immediately when injury occurs.

Coaches should manage players and spectators. A clear sideline allows responders to work. The absence of a medical professional increases the importance of the meeting. Planning replaces assumption.

The Emergency Action Plan
Every school should maintain a written Emergency Action Plan (EAP). The plan outlines the response to catastrophic injury. The document should identify roles, equipment and communication steps.

A pre-game meeting reviews the most critical parts of the plan. The meeting does not replace the written document; the meeting reinforces it.

The EAP should address several high-risk conditions:

• Cardiac arrest

• Head or spinal injury

• Heat illness

• Severe weather

Cardiac arrest requires the fastest response. Survival decreases by approximately 10 percent for every minute without defibrillation. Immediate access to an AED remains essential.

The meeting should confirm that the AED is functional and accessible.

Communication Matters
Clear communication saves time during emergencies, and time matters in medical care.

Officials, coaches, and medical personnel should exchange names. Radios or cell phones should be tested if used. Everyone should understand who contacts EMS.

Schools often overlook this step. The result is delay and confusion.

A 120-second meeting prevents that outcome.

Liability and Duty of Care
Schools have a duty to provide a safe environment for student- athletes. Courts examine preparation, training, and supervision when injuries occur. A consistent pre-game medical meeting demonstrates reasonable planning. Documentation of the practice strengthens that position.

The meeting also supports risk management policies. Insurance carriers often recommend formal emergency planning, and state high school associations increasingly encourage pre-event medical discussions.

Leaders should treat the meeting as a standard operating procedure.

Consistency matters – every game, every venue.

A Culture of Safety
A short meeting signals that safety matters. Coaches, officials and administrators share responsibility for athlete welfare. Athletes and parents expect preparation. Schools should meet that expectation. The meeting requires little time. The benefit can be life-saving.

Preparation is leadership. A two-minute conversation before competition reflects that leadership. High school sports teach discipline and teamwork. Safety must remain part of that lesson.

A pre-game medical time-out meeting makes that commitment visible. Performing the pre-game medical time-out meeting is the two-minute meeting that protects every athlete, and it is the smartest two minutes in high school sports!

Lee Mancini is chief of the Division of Sports and Exercise Medicine at the UMass Medical Center in Worcester, Massachusetts. He is a board-certified sports medicine physician, a certified sports nutritionist, and a certified strength and conditioning specialist. He is a member of the NFHS Sports Medicine Advisory Committee.

Gretchen Fowell, FNP-C, is a Family Nurse Practitioner with Great Falls OB/GYM Associates in Great Falls, Montana. She is a member of the NFHS Sports Medicine Advisory Committee.