On-Field Management: Cardiac Event.

Background: Sudden cardiac arrest (SCA) is the leading cause of sport-related death in athletes during competition despite their healthy physiological status. Sudden cardiac death is defined as an unexpected death from cardiac causes that occurs within 1 hour (or within 24 hours in unwitnessed cases) from the onset of an acute change in cardiovascular status in the absence of external causal factors. Medical personnel should be prepared to care for athletes who experience SCA and understand the factors that increase the chance of survival in athletes who experience SCA.

Indications: Being prepared for these events is essential for increasing the chance of survival in athletes who experience SCA. In addition to in-game management of a SCA, we review the causes of SCA, the role of screening and workup, implementation of an action plan, and the transition of care following an event.

Technique description: Emergency action plans (EAPs) are necessary to streamline and standardize efficient care for athletes who experience SCA. The EAP discussed in this article comprises 12 items that guide the management of SCA from appropriate setup and planning for each sporting venue to the postresuscitation transition of care.

Results: Athletes who experience SCA are more likely to survive if an automated external defibrillator (AED) is available and measures are taken to prepare the sideline medical team with an EAP that addresses conditions before and after the SCA event.

Discussion/conclusion: SCA is a serious event that all sideline personnel should be prepared for. With the presence of an AED and preparation of medical and training staff with an EAP, the likelihood of an athlete surviving a cardiac arrest increases substantially. Thus, medical and training staff should familiarize themselves with EAPs and rehearse them annually.

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