So far this year, two football players have died from traumatic brain injuries.
There is agreement on the need for certified athletic trainers, but there is also concern because some school systems can't afford to hire a qualified, licensed professional.
The death of Atlas Fraley in August shocked Chapel Hill High School and the Triangle community. The football player died at his home after a scrimmage.
Two more student athletes --Matt Gfeller of Winston-Salem and Jaquan Walker of Greenville-- also died this year.
Now the state high school athletic association is developing safety recommendations that could save lives.
"One of the recommendations is to have a licensed athletic trainer in all of our high schools," Wake Schools Athletics Director Bobby Guthrie said. "Wake County is able to do that, Durham County schools are able, but some systems are not."
The cost of a trainer for all 381 association schools is about $18 million, which would be a challenge, because the state is facing an economic crisis.
Officials are working on other ideas that won't be so expensive.
"There are some things that we can do at very low cost," said Kymm Ballard with the Department of Public Instruction. "So if we keep the focus on how do we make this a safer place for kids to participate, I think there are some thing that we can do."
She says hiring athletic trainers statewide might mean cuts of other scholastic programs, something authorities want to avoid.
A vote on the recommendations is scheduled for Wednesday or Thursday, but there could be some adjustments.