Abstract
Sudden cardiac arrest remains the leading cause of death in exercising athletes, and recent studies have shown that it occurs more frequently than historical estimates. While out-of-hospital cardiac arrest often proves fatal, advance preparation can improve outcomes and the chance of survival. First responders to a collapsed athlete on the field of play may include team medical personnel, coaches, other athletes, officials, venue staff, emergency medical services personnel, or lay bystanders. Prompt and accurate recognition of sudden cardiac arrest, a comprehensive and rehearsed emergency action plan, early cardiopulmonary resuscitation, and immediate access to and use of an automated external defibrillator are each pivotal links in the chain of survival. This review summarises the components of an effective emergency action plan, highlights the critical role of automated external defibrillators, and reviews the diagnosis and management of sudden cardiac arrest on the field of play.
Highlights
The sudden collapse and death of a young athlete on the field of play is a tragic event with a profound impact on the local community
Recent epidemiological data have shown that Sudden cardiac arrest (SCA) strikes competitive athletes more frequently than historical estimates
The Fédération Internationale de Football Association (FIFA) has begun a registry to study all cases of soccer-related SCA to better understand the extent of the problem [4]
Summary
The sudden collapse and death of a young athlete on the field of play is a tragic event with a profound impact on the local community. A comprehensive EAP includes training of likely first responders to a collapsed athlete, including on-site medical and club personnel, as well as access to an automated external defibrillator (AED), emergency medical services, and advanced care facilities (Tab. 1). Sudden cardiac arrest (SCA) in athletes is largely a survivable event (89%) with proper preparation and access to an AED. The collapse to defibrillation time should be under 3 minutes to allow a favorable outcome of survival. AEDs should be strategically located in the schools & community, arenas and along the full length of a mass-participation course to allow a favorable outcome. Personnel training: All potential first responders, including team medical staff (athletic trainers, physiotherapists, and physicians), coaches, and appropriate school or venue staff, should be trained in cardiopulmonary resuscitation (CPR) and the use of an AED. SCA should be assumed in any collapsed and unresponsive athlete and the EAP activated [17]
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