Although high school coaches are encouraged to obtain certifications in cardiopulmonary resuscitation (CPR), automated external defibrillators (AED), and first aid (FA), there is no national and few state mandates for coaches to maintain adequate knowledge regarding emergency care for youth athletes. As youth participation in organized events continues to grow, the incidence of injury and sudden death has subsequently increased. The purpose of this study was to investigate high school coaches' knowledge of basic FA, CPR, and AED. Coaches (N= 89, 21.3% females, 78.2% males) at a high school coaches' association state conference completed a demographics questionnaire and 20-question, multiple-choice survey about emergency medical care. Although 87.6% of coaches who participated were FA certified and 91% were CPR certified, results of the survey indicated a lack of knowledge of basic skill-related questions in the topics of youth CPR and AED. Based on the results of the current study, coaches did not retain adequate knowledge to act competently in the event of an emergency of cardiac origin. National standards for specific emergency care education and recertification should be implemented for all high school coaches (paid or volunteer); standards that would require coaches to stay current on emergency medical interventions.