Context: Secondary schools that offer school-sponsored athletic events should follow best-practice guidelines to provide policies that promote student health and safety.

Objective: To assess emergency preparedness from the perspective of athletic administrators (AAs) in [State] secondary schools.

Design: Cross-sectional study.

Setting: Online survey.

Patients or Other Participants: Ninety-eight AAs from [State] completed the survey (age=45.33 ± 10.22 years, years as an AA= 9.37 ± 8.14, years in current role=7.72 ± 7.09).

Intervention(s): Six-section survey, with questions about access to ATs, emergency action plans (EAPs), Cardiopulmonary resuscitation (CPR), automated external defibrillator (AED), concussions and heat illness.

Main outcome measures (s): Descriptive statistics (percentages and frequencies) were reported. Relative risk was calculated to compare schools with and without access to athletic trainers (ATs) (P<.05).

Results: Most respondents (76.5%, n = 75/98) reported their school had access to a licensed AT. The majority had a written EAP (83.3%, n = 70/84), but less than half (39.2%, n = 31/79) reviewed it annually and less than 10% (n=6/85) reported practicing it each year. All respondents (100%, n = 78/78) reported having an AED on campus. All respondents (n = 77/77) reported that they were familiar with the [State] High School Athletic Association's (XHSAA) concussion policy and had a concussion guideline in place. Many respondents (95.9%, n = 71/74) reported being familiar with the XHSAA's heat illness policy, but over half (62.1%, n = 41/66) reported not having a heat policy in place at their school.

Conclusions: Most respondents indicated their school has access to ATs, follows the state-mandated concussion guidelines, and has an AED. Although participants reported having written EAPs in place, there were low levels of annual EAP review and practice. These results suggest schools would benefit from educational opportunities to improve safety policies.

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