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RECOGNITION OF CARDIOGENIC COLLAPSE ON THE FIELD OF PLAY: BOWING, KNEELING AND PROSTRATION
  1. S Baltsezak
  1. Anglian Community Enterprise, Dept of MSK and Sports Medicine, Colchester, United Kingdom

Abstract

Background Sudden cardiac death/arrest (SCD/SCA) on the field of play remains one of the most tragic and challenging events for a team physician. Even with robust regular preparticipation cardiac screening we cannot prevent all cases of SCA/SCD. Ability to recognise imminent cardiac arrest occurring on the field of play remains an important step in managing this condition without delay.

Objective The purpose of this study was to more closely characterise the presentation of cardiogenic collapse on the field of play.

Methods You Tube was searched for video clips clearly depicting sequence of athlete's collapse of cardiac origin. A pattern of collapse was subsequently analysed.

Results 13 cases were available for public viewing on You Tube and demonstrated final position of collapse. 12 collapses had full video footage of athlete's fall. All athletes were men. 84.6% (11) cases were from football (soccer). 15.4% (2) of cases were from martial arts. In 10 out of 12 cardiac event cases (83.3%) bowing and/or kneeling were followed by decubitus position. 58.3% (7) of cases demonstrated bowing at the beginning of collapse. 58.3% (7) cases had kneeling as an element of collapse. 61.5% (8 out of 13 cases) of casualties adopted position of ‘prostration’ as final stage of collapse.

Conclusion When on the field of play, in the absence of head injury, athletes displaying bowing and/or kneeling positions followed by collapse may experience a life threatening cardiac event. Final position of 'prostration' was adopted in over half of cardiogenic collapses. Sports physician attending such casualties should bear this in mind and target his/her initial and subsequent assessment and treatment accordingly. A defibrillator should be taken to the player when attending such casualties.

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