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Cardiac player health and safety: a call to action
  1. Matthew Martinez1,
  2. Jonathan H Kim2,
  3. Eli M Friedman3,
  4. Eugene H Chung4
  1. 1 Morristown Medical Center, Morristown, New Jersey, USA
  2. 2 Emory University, Atlanta, Georgia, USA
  3. 3 Miami Cardiac & Vascular Institute, Miami, Florida, USA
  4. 4 Cardiology, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr Matthew Martinez, Morristown Medical Center, Morristown, USA; Matthew.Martinez{at}

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On 2 January 2023, Damar Hamlin of the Buffalo Bills suffered sudden cardiac arrest (SCA) in front of millions of viewers on Monday Night Football, and on 16 December 2023, international football (soccer) star Tom Lockyer suffered SCA on the pitch in Luton’s match against Bournemouth. These events are a stark reminder that the keystone of cardiac health and safety in athletes is a well-planned, well-rehearsed emergency action plan (EAP) with an emphasis on rapid cardiopulmonary resuscitation (CPR) and automatic external defibrillator (AED) use. Thankfully, while SCA in athletes on the competitive field is infrequent,1–3 failure to immediately recognise SCA and rapidly execute an EAP can cost lives. Similar to relying on years of training for competitive sports, rapid response to an SCA requires preparation and training. Indeed, the immediate response in Hamlin’s case was planned for and rehearsed; the National Football League and many other professional sporting organisations require a preseason hands-on rehearsal of medical emergencies and also have a ‘medical timeout’ prior to all formal competitions to review the EAP and assign responsibilities should SCA or other emergencies arise. EAPs are recommended for every organisation, school or institution that sponsors athletic or performance activity and are required at the collegiate and professional levels.4–6 Figure 1 illustrates the key components of a cardiac EAP.

Figure 1

Core principles of a cardiac emergency action plan (EAP). AED, automated external defibrillator; CPR, cardiopulmonary resuscitation; SCA, sudden cardiac arrest.

In general, an EAP coordinator should lead the planning and documentation of the …

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  • Contributors All authors have contributed to the manuscript equally with the first author doing the majority of the writing. The other authors were involved in review, concept generation and figure making.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.