Abstract
Sudden death in athletes occurs approximately once every 3 days in the United States. Each school or venue should have an emergency action plan that is coordinated with local emergency medical services (EMS). Access to early defibrillation to treat sudden cardiac arrest (SCA) is critical. If EMS response times are greater than 3 to 5 minutes from collapse to first shock, an on-site automated external defibrillator (AED) should be available. Delays in recognition of SCA in athletes occur commonly. Any collapsed and unresponsive athlete should be considered to be in cardiac arrest and an AED should be applied for rhythm analysis as soon as possible. Cardiopulmonary resuscitation should be provided while waiting for an AED and interruptions in chest compressions should be minimized. Rehearsal of the emergency action plan with potential first responders is essential to ensuring an efficient response to SCA in athletics.
Similar content being viewed by others
References and Recommended Reading
Drezner JA, Courson RW, Roberts WO, et al.: Interassociation task force recommendations on emergency preparedness and management of sudden cardiac arrest in high school and college athletic programs: a consensus statement. J Athl Train 2007, 42:143–158.
American Heart Association: 2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2005, 112(24 Suppl):IV1–IV203.
Hazinski MF, Markenson S, Neish, S, et al.: Response to cardiac arrest and selected life-threatening emergencies: the medical emergency response plan for schools: a statement for healthcare providers, policymakers, school administrators, and community leaders. Circulation 2004, 109:178–191.
Andersen JC, Courson RW, Kleiner DM, McLoda TA: National Athletic Trainers’ Association position statement: emergency planning in athletics. J Athl Train 2002, 37:99–104.
American Academy of Pediatrics: Guidelines for emergency medical care in school. Committee on School Health. Pediatrics 2001, 107:435–436.
Sideline preparedness for the team physician: a consensus statement. Med Sci Sports Exerc 2001, 33:846–849.
Van Camp SP, Boor CM, Mueller FO, et al.: Nontraumatic sports death in high school and college athletes. Med Sci Sports Exerc 1995, 27:641–647.
Maron BJ, Shirani J, Poliac LC, et al.: Sudden death in young competitive athletes. Clinical, demographic, and pathological profiles. JAMA 1996, 276:199–204.
Drezner JA, Rogers KJ, Zimmer RR, Senett BJ: Use of automated external defibrillators at NCAA Division I Universities. Med Sci Sports Exerc 2005, 37:1487–1492.
Corrado D, Basso C, Pavei A, et al.: Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program. JAMA 2006, 296:1593–1601.
Maron BJ, Doerer JJ, Haas TS, et al.: Profile and frequency of sudden death in 1463 young competitive athletes: from a 25 year U.S. national registry: 1980–2005. American Heart Association Scientific Sessions. Chicago, IL: November 12–15, 2006.
Maron BJ: Sudden death in young athletes. N Engl J Med 2003, 349:1064–1075.
Maron BJ, Thompson PD, Puffer JC, et al.: Cardiovascular preparticipation screening of competitive athletes. A statement for health professionals from the Sudden Death Committee and Congenital Cardiac Defects Committee. American Heart Association. Circulation 1996, 94:1493–501.
American Academy of Family Physicians, American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopedic Society for Sports Medicine, American Osteopathic Association of Sports Medicine. Preparticipation Physical Evaluation, edn 3. New York: McGraw-Hill; 2005.
Glover DW, Maron BJ: Profile of preparticipation cardiovascular screening for high school athletes. JAMA 1998, 279:1817–1819.
Pfister GC, Puffer JC, Maron, BJ: Preparticipation cardiovascular screening for US collegiate student-athletes. JAMA 2000, 283:1597–1599.
Basso C, Maron BJ, Corrado D, Thiene G: Clinical profile of congenital coronary artery anomalies with origin from the wrong sinus leading to sudden death in young competitive athletes. J Am Coll Cardiol 2000, 35:1493–1501.
Corrado D, Pelliccia A, Bjornstad HH, et al.: Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol. Consensus Statement of the Study Group of Sport Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Eur Heart J 2005, 25:516–524.
Thompson PD, Levine BD: Protecting athletes from sudden cardiac death. JAMA 2006, 296:1648–1650.
Marenco JP, Wang PJ, Link MS, et al.: Improving survival from sudden cardiac arrest: the role of the automated external defibrillator. JAMA 2001, 285:1193–1200.
Larsen MP, Eisenberg MS, Cummins RO, Hallstron AP: Predicting survival from out-of-hospital cardiac arrest: a graphic model. Ann Emerg Med 1993, 22:1652–1658.
Hallstrom AP, Ornato JP, Weisfeldt M, et al.: and the Public Access to Defibrillation Trial Investigators: Public access defibrillation and survival after out-of-hospital cardiac arrest. N Engl J Med 2004, 351:637–646.
Drezner JA, Rogers KA: Sudden cardiac arrest in inter-collegiate athletes: detailed analysis and outcomes of resuscitation in nine cases. Heart Rhythm 2006, 3:755–759.
Rothmier JD, Drezner JA, Harmon KG: Automated external defibrillators in Washington State high schools. Br J Sports Med 2007, 41:301–305.
Guidelines 2000 for Cardiopulmonary resuscitation and emergency cardiovascular care. Part 4: the automated external defibrillator: key link in the chain of survival. The American Heart Association in Collaboration with the International Liaison Committee on Resuscitation. Circulation 2000, 102(8 Suppl):I-60–I-76.
Robertson RM: Sudden death from cardiac arrest—improving the odds. N Engl J Med 2000, 343:1259–1260.
Page RL, Joglar JA, Kowal RC, et al.: Use of automated external defibrillators by a U.S. airline. N Engl J Med 2000, 343:1210–1216.
Valenzuela TD, Roe DJ, Nichol G, et al.: Outcomes of rapid defibrillation by security officers after cardiac arrest in casinos. N Engl J Med 2000, 343:1206–1209
White RD, Asplin BR, Bugliosi TF, et al.: High discharge survival rate after out-of-hospital ventricular fibrillation with rapid defibrillation by police and paramedics. Ann Emerg Med 1996, 28:480–485.
White RD, Hankins DG, Bugliosi TF: Seven years’ experience with early defibrillation by police and paramedics in an emergency medical services system. Resuscitation 1998, 39:145–151.
White RD, Hankins DG, Atkinson EJ: Patient outcomes following defibrillation with a low energy biphasic truncated exponential waveform in out-of-hospital cardiac arrest. Resuscitation 2001, 49:9–14.
Bunch TJ, White RD, Gersh BJ, et al.: Long-term outcomes of out-of-hospital cardiac arrest after successful early defibrillation. N Engl J Med 2003, 348:2626–2633.
Nichol G, Stiell IG, Laupacis A, et al.: A cumulative meta-analysis of the effectiveness of defibrillator-capable emergency medical services for victims of out-of-hospital cardiac arrest. Ann Emerg Med 1999, 34(Pt 1):517–525.
Bergfeldt L: Differential diagnosis of cardiogenic syncope and seizure disorders. Heart 2003, 89:353–358.
Terry GC, Kyle JM, Ellis JM, et al.: Sudden cardiac arrest in athletic medicine. J Athl Train 2001, 36:205–209.
Ruppert M, Reith MW, Widmann JH, et al.: Checking for breathing: evaluation of the diagnostic capability of emergency medical services personnel, physicians, medical students, and medical laypersons. Ann Emerg Med 1999, 34:720–729.
American Heart Association: 2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Part 4: adult basic life support. Circulation 2005, 112(24 Suppl):IV-19–IV-34.
Eberle B, Dick WF, Schneider T, et al.: Checking the carotid pulse check: diagnostic accuracy of first responders in patients with and without a pulse. Resuscitation 1996, 33:107–116.
Holmberg M, Holmberg S, Herlitz J: Factors modifying the effect of bystander cardiopulmonary resuscitation on survival in out-of-hospital cardiac arrest patients in Sweden. Eur Hear J 2001, 22:511–519.
Holmberg M, Holmberg S, Herlitz J, Gardelov B: Survival after cardiac arrest outside hospital in Sweden. Swedish Cardiac Arrest Registry. Resuscitation 1998, 36:29–36.
Stiell I, Nichol G, Wells G, et al.: Health-related quality of life is better for cardiac arrest survivors who received citizen cardiopulmonary resuscitation. Circulation. 2003, 108:1939–1944.
Cobb LA, Fahrenbruch CE, Walsh TR, et al.: Influence of cardiopulmonary resuscitation prior to defibrillation in patients with out-of-hospital ventricular fibrillation. JAMA 1999, 281:1182–1188.
Carpenter J, Rea TD, Murray JA, et al.: Defibrillation wave-form and post-shock rhythm in out-of-hospital ventricular fibrillation cardiac arrest. Resuscitation 2003, 59:189–196.
American Heart Association: 2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Part 5: adult basic life support. Circulation 2005, 112(24 Suppl):IV-35–IV-46.
Wik L, Hansen TB, Fylling F, et al.: Delaying defibrillation to give basic cardiopulmonary resuscitation to patients with out-of-hospital ventricular fibrillation: a randomized trial. JAMA 2003, 289:1389–1395.
England H, Weinberg PS, Estes NA: The automated external defibrillator: clinical benefits and legal liability. JAMA 2006, 295:687–690.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Harmon, K.G., Drezner, J.A. Update on sideline and event preparation for management of sudden cardiac arrest in athletes. Curr Sports Med Rep 6, 170–176 (2007). https://doi.org/10.1007/s11932-007-0024-9
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11932-007-0024-9