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FROM TIME TO time, everyone needs a wake-up call to get back on course, to regain focus and to get with the program. That time is at hand in high [...]

INAPPROPRIATE ADULT behavior at high school athletic events throughout the country has reached epidemic proportions. When more than 2,000 high school athletic directors were asked in a recent national survey [...]

Context: Among American sports, football has the highest incidence of exertional heat stroke (EHS), despite decades of prevention strategies. Based on recent reports, 100% of high school and college EHS football fatalities occur during conditioning sessions. Linemen are the at-risk population, constituting 97% of football EHS deaths. Linemen heat up faster and cool down slower than other players.Evidence Acquisition: Case series were identified from organized, supervised football at the youth, high school, and collegiate levels and compiled in the National Registry of Catastrophic Sports Injuries. Sources for event occurrence were media reports and newspaper clippings, autopsy reports, certificates of death, school-sponsored investigations, and published medical literature. Articles were identified through PubMed with search terms “football,” “exertional heat stroke,” and “prevention.”Study Design: Clinical review.Level of Evidence: Level 5.Results: Football EHS is tied to (1) high-intensity drills and conditioning that is not specific to individual player positions, (2) physical exertion as punishment; (3) failure to modify physical activity for high heat and humidity, (4) failure to recognize early signs and symptoms of EHS, and (5) death when cooling is delayed.Conclusion: To prevent football EHS, (1) all training and conditioning should be position specific; (2) physical activity should be modified per the heat load; (3) understand that some players have a “do-or-die” mentality that supersedes their personal safety; (4) never use physical exertion as punishment; (5) eliminate conditioning tests, serial sprints, and any reckless drills that are inappropriate for linemen; and (6) consider air-conditioned venues for linemen during hot practices. To prevent EHS, train linemen based on game demands.Strength-of-Recommendation Taxonomy: n/a.

The article informs focuses on the impact of COVID-19 pandemic on shortage of officials in high school and middle school sports in the U.S. It mentions that Tennessee and Georgia have reported declines in baseball umpires. It also mentions that vaccinations increase and the optics improve may make many officials return.