Monsignor Pace High (Opa Locka, Fla.) football coach Joe Zaccheo was the third person to reach Brian Bell's side seconds after the Spartans' senior strong safety dropped like a stone on the practice field earlier this month. What Zaccheo witnessed that day changed him forever.

Just 10 days removed from his most recent physical, Bell, 17, became the first of two well publicized, medically related deaths involving high school football players this preseason. Saline High (Ann Arbor, Mich.) junior lineman Jeremy Tarlea, 15, died on Aug. 16, a week after suffering heatstroke in practice. In Bell's case, one of the two arteries that fed his heart blood had been bent in half since birth.

"Brian was gone before he hit the ground," says Zaccheo. "I'm a father, too, you know? To see him lying there and know in my heart he was gone, and to find out later he could have led a normal life if that defect had been detected. Well, that's why I've become a crusader of sorts for 'better safe than sorry' as far as (preseason medical) screenings go."

But are such deaths avoidable - The search for an answer unearthed some sobering details.

According to a University of North Carolina study released earlier this month, 17 high school-age football players across the country died last year. Researchers found 10 of those deaths, like Bell's, were caused by heart failure or other conditions related to exertion. Two others died from heatstroke, as in the case of Tarlea, while the remaining five fatalities were attributed to on-the-field head injuries.

That reality presents an unnerving dynamic in most high school locker rooms: kids who simply aren't being examined thoroughly enough to know if they're at risk.

"After doing some research on this, I have to question the logic behind how well we test athletes in this country," says Zaccheo. "Even at the professional level. We never had a certified trainer at our high school until this past year, and the medical [screening] that the state required for years is a piece of crap. It doesn't do anything. The state has since come up with one that's much more comprehensive, but it's still just a general physical."

"Most of the group of diseases that are the main cause of this syndrome can be identified by an electrocardiogram (EKG)," says Dr. Robert Myerburg, Professor of Medicine and Physiology, and Director of Cardiology at the University of Miami's Jackson Memorial Hospital. "Because of that, I think EKGs should be done on all high school athletes and, in fact, all high school kids. That's the age these problems show up."

In Bell's case, even an EKG wouldn't have revealed his congenital defect, but it would have shown evidence of a previous heart attack. That would have been enough to warrant an additional and more thorough examination.

Myerburg, who arranged for all Monsignor Pace players to undergo an EKG after hearing of Bell's death, says there is plenty of opposition to his idea of EKGs for all. The counter-argument centers on cost-inefficiency, which makes those in the health-care industry pretty hot.

"You can't put a value on those lives and, even without much shopping around, the cost is ultimately less than an annual set of dental X-rays," says Myerburg.

"Japan and Italy already require all high school athletes to have an EKG," adds Zaccheo, who is also the president of the Miami-Dade County Football Coaches' Association. "You're going to tell me they can get it done and we can't?"

Unless and until EKGs become standard in preseason medical screenings, players' medical histories remain the best indicator. According to Myerburg, any history of sudden cardiac death in one's family is a colossal warning flag. Fainting spells, chest pains or a rapid heartbeat are additional indicators.

As for heatstroke, coaches across the country are looking to better educate their players regarding proper hydration.

"You've got momma's little boy out there and you've got to be careful," says Holmes High (San Antonio, Texas) head football coach David Sanchez. "The main thing is getting these kids to water anytime they need it. We have (six) separate water stations with a student trainer tending (each) next to every group at practice.

"Once you lose a kid to heat stroke, he's gone for five to seven days. And then he's more prone to it in the future," adds Sanchez. "I'd rather have him take his time getting conditioned than have the alternative happen."