Rewind 40 years. High school sports were without state-mandated concussion testing. In fact, the general public, as well as doctors knew very little about the long term effects concussions could have on an adolescent.

Hydrating during a steamy summer day was considered a sign of weakness, and first responders were not required to be present during football practices or games.

We’ve come a long way in 40 years, and the Beaufort County school system continues to exceed state requirements to ensure each student athlete competes in the safest possible environment. Washington certified athletic trainer Jeff Mault, a veteran in the field of sports medicine, is required by law to be present at every football-related event.

“I’m very confident in Jeff,” said Joe Tkach, county athletic director for Beaufort County. “I used to tell him if he ever had any problems with any coaches to come see me. I think the coaches really appreciate a first responder or athletic trainer because when one of your kids goes down, it’s a bad feeling.”

In football, concussions are one of the most common and dangerous injuries a student athlete can endure. The NCAA continues to study the short and long term effect the injury can have on a player, and initiatives to make the game safer are constantly in the spotlight.

For high school sports, the Gfeller-Waller Concussion Awareness Act implemented in 2011 mandates every coach and trainer to be educated in emergency concussion management and postconcussion protocol.

“Once [a player] is suspected of having a concussion, he cannot return to play that day—no matter what—and he can’t return until a doctor has cleared him,” Tkach said. “If a doctor says he had a concussion but he’s ok to return, he then has to go through five stages of gradual return.”

Even when a player no longer shows symptoms of a concussion, he has to begin with light cardio, usually on a stationary bicycle, which has to be observed by a coach. After successfully raising his heart rate with no physical symptoms, the athlete can then move to moderate jogging. The third step consists of typical, non-contact exercises like weightlifting routines and sprints. Then, and only then, can the player return to practice.

While the state mandates an athletic trainer to be present at football games, Beaufort County exceeds the state’s obligation, paying stipends to multiple first responders in some cases to monitor a range of athletic events.

“An athletic trainer or first responder is required to be at every football practice,” Tkach said. “Now in our county, we don’t pay for a certified athletic trainer or first responder just for football. We divide it into fall, winter and spring seasons. Some schools will get different first responders so one person doesn’t have to be out there every day. At one point I think Northside had three—one for each season.”

While not required, Beaufort County coaches are not only certified in CPR, but licensed to teach a course in it. And with the majority of coaches being physical educators, AED defibrillator and first aid licensure are also common attributes for a typical Beaufort County coach. For those coaches who aren’t physical educators, the school system offers CPR and first aid courses.

Preseason meetings conducted by each school’s athletic director prior to each sport’s first game assures that coaches are knowledgeable in required injury protocol and parents are aware of the county’s medical insurance policy.

“Our county buys secondary athletic coverage,” Ktach said. “If you get injured, your insurance is going to pay first, secondary ours will kick in. Any kid that gets injured, they need to fill out a form regardless of whether the parents take them to a doctor or not.”

Whether it’s Allison Jones at Washington or Sean White at Southside, each athletic director is responsible for maintaining a safe playing environment for their student athletes. We’ve come a long way in 40 years, and as sports medicine advances, safety protocol in high school athletics will only continue to progress.