GLOCESTER, R.I. (WPRI) — When Buffalo Bills safety Damar Hamlin collapsed in cardiac arrest during a Monday Night Football game in January, it underscored the important role of those who helped save his life: athletic trainers.

But data from Rhode Island public high schools shows less than a quarter of districts have full-time athletic trainers, or just five out of 21 school districts. The rest reported using per-diem or part-time athletic trainers or said they depend on EMTs to show up during games.

Several districts with part-time coverage reported prioritizing football games, sometimes leaving other full-contact sports like ice hockey, lacrosse or basketball uncovered.

Ten school districts did not respond to Target 12’s repeated requests for information.

Like Hamlin, George Hanrahan experienced cardiac arrest after an accidental hit to the chest, his occurring with a student-athlete while he was refereeing a Ponaganset High School girls basketball game in 2018.

Salvatore Palermo, the high school’s athletic trainer, jumped up and rushed to Hanrahan’s side. Palermo said he and North Providence fire marshal Marc Rizzo, who was in the stands that day, checked Hanrahan’s vital signs, performed CPR and brought him back to consciousness.

“The legs were definitely shaking after that one,” Palermo said. “That’s just one day I’ll probably never ever forget in my life.”

Hanrahan told Target 12 that their quick response has added years to his life.

“I would’ve died,” Hanrahan told Target 12. “I’m alive because of it–I’m alive because someone knew how to do what they did.”

Kristina Keddie, president of the Rhode Island Athletic Trainers Association called athletic trainers “crucial and important for every secondary school — public, private — in the state of Rhode Island.”

But Keddie said in the absence of a trainer, emergency action plans can provide a valuable safety net for schools.

The R.I. Interscholastic League — a nonprofit that supervises athletic programs for more than 60 public and private high schools statewide — recommends that every school create an action plan, which assigns coaches and staff specific jobs during an emergency.

“Maybe it’s to flag down the ambulance and guide them onto the field for quick, easy access, or crowd control,” said Jennifer Gallant, athletic trainer at Lincoln School.

Another part of that safety net: high school coaches are required to be CPR and first-aid certified statewide.

But Gallant said to create the best emergency action plan, “having a full-time athletic trainer really guides that process, guides that athletic department.”

RIIL executive director Michael Lunney told Target 12 the shortage of athletic trainers has happened over the past few years in Rhode Island and nationally. To become one, you now need to have a master’s degree, and Lunney said students have to go to Massachusetts or Connecticut to get that degree.

“We need more trainers certified,” Lunney said.

He added that many districts want to hire a full-time athletic trainer and have set aside the funds to do so, but “they’re just not available.”

Ponaganset High School is part of the Foster-Glocester school district, which is one of just five districts that reported having a full-time athletic trainer at every high school.

Superintendent Renee Palazzo told Target 12 having a full-time athletic trainer helps ensure that students are safe at all times. She said the district’s emergency action plan was first implemented in 2013 and is reviewed annually.

“In my case, someone was qualified and it saved my life,” Hanrahan said.