Chapel Hill, N.C. — A panel of sports medicine experts said Thursday that any high school athlete suspected of suffering a concussion must be cleared by a physician before he or she can play or practice.

The medical committee of the North Carolina High School Athletic Association also established a task force to determine whether high schools should be required to have certified athletic trainers on staff. The task force is expected to make a recommendation at the association's annual meeting in December.

The moves come in the wake of the recent deaths of three North Carolina high school football players, two of whom died from head injuries. The committee rescheduled its regular meeting from March 2009 to more quickly address the issues surrounding their deaths.

"We need to err on the side of caution. Keep them out. Get them referred to a physician," said Dr. Kevin Guskiewicz, chairman of the Department of Exercise and Sport Science at the University of North Carolina-Chapel Hill and a committee member.

The committee received reports outlining the deaths of Atlas Fraley, 17, of Chapel Hill High School, Juquan Waller, 17, of J.H. Rose High School in Greenville, and Matt Gfeller, 15, of Reynolds High School in Winston-Salem.

Fraley’s parents found him unresponsive on the evening of Aug. 12 at the family’s home, hours after he had participated in a football scrimmage.

An autopsy report hasn't been completed, but the NCHSAA report noted he collapsed from heat exhaustion.

Fraley called 911 that afternoon and said he felt dehydrated. Paramedics were sent to his home, but he wasn't taken to a hospital for treatment.

Both Orange County EMS and Chapel Hill-Carrboro City Schools are investigating the circumstances surrounding Fraley's death. Neither investigation has been completed.

Waller, a junior running back, left the field after being tackled in a game and then collapsed on the sideline. He was taken to Pitt Memorial Hospital, where he was placed on life support. He died on Sept. 20.

He had been hit in practice two days before the game and suffered a mild concussion, and a medical examiner determined the cause of death to be "second-impact syndrome," where a person receives two or more blows to the head in a short period.

Gfeller died Aug. 24, two days after a hit that he took in a game against Greensboro Page High School led to cranial bleeding.

The committee's recommendation requiring written permission from a physician before a player can resume practice and game play after suffering a suspected concussion is effective immediately, members said.

The panel also said schools need to file emergency action plans with the NCHSAA detailing how they respond to player injuries, and they also need to certify the credentials of their athletic trainers or first-responders.

Schools now must have a first-responder trained in CPR and first aid on staff. Although some committee members argued that training isn't enough to prevent another sports-related death, others feared hiring certified athletic trainers would be too expensive for some schools.

"(Trainers) have a lenghty course of study on sports-related injuries that includes that of sport concussion," Guskiewicz said.

Less than 35 percent of North Carolina high schools have certified trainers, who have an average salary of about $40,000 a year.

Guskiewicz said the risk of injury is so great that schools without certified trainers shouldn't be playing contact sports.

"If we can't put kids out on the fields in a safe manner, then we shouldn't be putting them out there," he said.

Chapel Hill High has a certified athletic trainer on staff, and he was at the football scrimmage the morning of Fraley's death, Principal Jackie Ellis said.