Skip to main content
Log in

Design and Implementation of an Emergency Action Plan for Sudden Cardiac Arrest in Sport

  • Review Article
  • Published:
Journal of Cardiovascular Translational Research Aims and scope Submit manuscript

Abstract

Sudden cardiac arrest (SCA) is the leading cause of exercise-related fatalities in athletes. A comprehensive emergency action plan (EAP) is critical to facilitate a rapid and effective response to a cardiac emergency. SCA should be suspected in any athlete that collapses suddenly and is unresponsive. All potential responders to a collapsed athlete should be trained in the recognition of SCA, cardiopulmonary resuscitation, and use of an automated external defibrillator (AED). AEDs should be accessible on-site at sporting venues with a target collapse to first shock interval of less than 3 min. Every school, club, and sporting organization that sponsors athletic activities should have a written EAP for SCA. An EAP coordinator should be designated to foster compliance with training, practice, and rehearsal of the EAP at least once annually. Some sports require special considerations for equipment removal or access to emergency services in geographically broad or water-based venues.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Harmon, K. G., Asif, I. M., Maleszewski, J. J., et al. (2016). Incidence and etiology of sudden cardiac arrest and death in high school athletes in the United States. Mayo Clinic Proceedings, 91(11), 1493–1502.

    Article  PubMed  Google Scholar 

  2. Maron, B. J., Doerer, J. J., Haas, T. S., Tierney, D. M., & Mueller, F. O. (2009). Sudden deaths in young competitive athletes: Analysis of 1866 deaths in the United States, 1980-2006. Circulation., 119(8), 1085–1092.

    Article  PubMed  Google Scholar 

  3. Harmon, K. G., Asif, I. M., Maleszewski, J. J., et al. (2015). Incidence, cause, and comparative frequency of sudden cardiac death in National Collegiate Athletic Association Athletes: A decade in review. Circulation., 132(1), 10–19.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Maron, B. J., Haas, T. S., Murphy, C. J., Ahluwalia, A., & Rutten-Ramos, S. (2014). Incidence and causes of sudden death in U.S. college athletes. Journal of the American College of Cardiology, 63(16), 1636–1643.

    Article  PubMed  Google Scholar 

  5. Toresdahl, B. G., Rao, A. L., Harmon, K. G., & Drezner, J. A. (2014). Incidence of sudden cardiac arrest in high school student athletes on school campus. Heart Rhythm, 11(7), 1190–1194.

    Article  PubMed  Google Scholar 

  6. Drezner, J. A., O’Connor, F. G., Harmon, K. G., et al. (2016). AMSSM position statement on cardiovascular Preparticipation screening in athletes: Current evidence, knowledge gaps, recommendations, and future directions. Clinical Journal of Sport Medicine, 26(5), 347–361.

    PubMed  Google Scholar 

  7. Hainline, B., Drezner, J. A., Baggish, A., et al. (2016). Interassociation consensus statement on cardiovascular care of college student-athletes. Journal of the American College of Cardiology, 67(25), 2981–2995.

    Article  PubMed  Google Scholar 

  8. Drezner, J. A., & Rogers, K. J. (2006). Sudden cardiac arrest in intercollegiate athletes: Detailed analysis and outcomes of resuscitation in nine cases. Heart Rhythm, 3(7), 755–759.

    Article  PubMed  Google Scholar 

  9. Drezner, J. A., Rao, A. L., Heistand, J., Bloomingdale, M. K., & Harmon, K. G. (2009). Effectiveness of emergency response planning for sudden cardiac arrest in United States high schools with automated external defibrillators. Circulation., 120(6), 518–525.

    Article  PubMed  Google Scholar 

  10. Corrado, D., Basso, C., Rizzoli, G., Schiavon, M., & Thiene, G. (2003). Does sports activity enhance the risk of sudden death in adolescents and young adults? Journal of the American College of Cardiology, 42(11), 1959–1963.

    Article  PubMed  Google Scholar 

  11. Meeuwisse, W. H., Schneider, K. J., Dvořák, J., et al. (2017). The Berlin 2016 process: A summary of methodology for the 5th international consensus conference on concussion in sport. British Journal of Sports Medicine, 51(11), 873–876.

    Article  PubMed  Google Scholar 

  12. Drezner, J. A. (2009). Preparing for sudden cardiac arrest--the essential role of automated external defibrillators in athletic medicine: A critical review. British Journal of Sports Medicine, 43(9), 702–707.

    Article  CAS  PubMed  Google Scholar 

  13. Neumar, R. W., Shuster, M., Callaway, C. W., et al. (2015). Part 1: Executive summary: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation., 132(18 Suppl 2), S315–S367.

    Article  PubMed  Google Scholar 

  14. Monsieurs, K. G., Nolan, J. P., Bossaert, L. L., et al. (2015). European resuscitation council guidelines for resuscitation 2015: Section 1. Executive summary. Resuscitation., 95, 1–80.

    Article  PubMed  Google Scholar 

  15. Sasson, C., Rogers, M. A., Dahl, J., & Kellermann, A. L. (2010). Predictors of survival from out-of-hospital cardiac arrest: A systematic review and meta-analysis. Circulation. Cardiovascular Quality and Outcomes, 3(1), 63–81.

    Article  PubMed  Google Scholar 

  16. Bækgaard, J. S., Viereck, S., Møller, T. P., Ersbøll, A. K., Lippert, F., & Folke, F. (2017). The effects of public access defibrillation on survival after out-of-hospital cardiac arrest: A systematic review of observational studies. Circulation., 136(10), 954–965.

    Article  PubMed  Google Scholar 

  17. Blom, M. T., Beesems, S. G., Homma, P. C., et al. (2014). Improved survival after out-of-hospital cardiac arrest and use of automated external defibrillators. Circulation., 130(21), 1868–1875.

    Article  PubMed  Google Scholar 

  18. Berdowski, J., Schulten, R. J., Tijssen, J. G., van Alem, A. P., & Koster, R. W. (2010). Delaying a shock after takeover from the automated external defibrillator by paramedics is associated with decreased survival. Resuscitation., 81(3), 287–292.

    Article  PubMed  Google Scholar 

  19. Drezner, J. A., Toresdahl, B. G., Rao, A. L., Huszti, E., & Harmon, K. G. (2013). Outcomes from sudden cardiac arrest in US high schools: A 2-year prospective study from the National Registry for AED use in sports. British Journal of Sports Medicine, 47(18), 1179–1183.

    Article  PubMed  Google Scholar 

  20. Kinoshi, T., Tanaka, S., Sagisaka, R., et al. (2018). Mobile automated external defibrillator response system during road races. The New England Journal of Medicine, 379(5), 488–489.

    Article  PubMed  Google Scholar 

  21. Link, M. S., Myerburg, R. J., Estes, N. A., & American Heart Association Electrocardiography and Arrhythmias Committee of Council on Clinical Cardiology CoCDiY, Council on Cardiovascular and Stroke Nursing, C.uncil on Functional Genomics and Translational Biology, and American College of Cardiology. (2015). Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 12: Emergency Action Plans, Resuscitation, Cardiopulmonary Resuscitation, and Automated External Defibrillators: A Scientific Statement From the American Heart Association and American College of Cardiology. Circulation, 132(22), e334–e338.

    PubMed  Google Scholar 

  22. Drezner, J. A., Courson, R. W., Roberts, W. O., Mosesso, V. N., Link, M. S., & Maron, B. J. (2007). Inter-association task force recommendations on emergency preparedness and management of sudden cardiac arrest in high school and college athletic programs: A consensus statement. Clinical Journal of Sport Medicine, 17(2), 87–103.

    Article  PubMed  Google Scholar 

  23. Casa, D. J., Almquist, J., Anderson, S. A., et al. (2013). The inter-association task force for preventing sudden death in secondary school athletics programs: Best-practices recommendations. Journal of Athletic Training, 48(4), 546–553.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Bernard, S. A., Gray, T. W., Buist, M. D., et al. (2002). Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. The New England Journal of Medicine, 346(8), 557–563.

    Article  PubMed  Google Scholar 

  25. Webner, D., DuPrey, K. M., Drezner, J. A., Cronholm, P., & Roberts, W. O. (2012). Sudden cardiac arrest and death in United States marathons. Medicine and Science in Sports and Exercise, 44(10), 1843–1845.

    Article  PubMed  Google Scholar 

  26. Redelmeier, D. A., & Greenwald, J. A. (2007). Competing risks of mortality with marathons: Retrospective analysis. BMJ., 335(7633), 1275–1277.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Henry F. Pelto.

Ethics declarations

Conflict of Interest

Henry F Pelto declares that he has no conflict of interest.

Jonathan A Drezner declares that he has no conflict of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Additional information

Associate Editor Domingo A. Pascual-Figal oversaw the review of this article

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pelto, H.F., Drezner, J.A. Design and Implementation of an Emergency Action Plan for Sudden Cardiac Arrest in Sport. J. of Cardiovasc. Trans. Res. 13, 331–338 (2020). https://doi.org/10.1007/s12265-020-09988-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12265-020-09988-1

Keywords

Navigation