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Cardiac Arrest in Football

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Introduction

While rare, cardiac arrest is a serious medical emergency that can occur on the football field. In this blog, we will review into the causes, risk factors, preventive measures, and emergency response strategies related to cardiac arrest in football. Understanding this critical aspect of the game can help create a safer environment for players and ensure a swift and effective response in times of medical crisis.

What is Cardiac Arrest?

Cardiac arrest is a sudden and unexpected loss of heart function, resulting in the cessation of blood flow to vital organs. It can happen without warning and requires immediate attention to improve the chances of survival. While rare in football, the severity of cardiac arrest necessitates preparedness and awareness among players, coaching staff, and medical professionals.

Cardiac Arrest in Football

Recognising Cardiac Arrest

Early recognition of cardiac arrest is crucial for initiating prompt and life-saving interventions. As a player, coach, or medical personnel, it is essential to be vigilant and aware of the following signs:

  • Sudden Collapse: If a player suddenly collapses on the field and is unresponsive, cardiac arrest should be suspected.
  • No Breathing or Abnormal Breathing: Check for breathing. If the player is not breathing or gasping for air, it may indicate cardiac arrest.
  • Absence of Pulse: Check for a pulse at the carotid artery (neck) or radial artery (wrist). If no pulse is detected, it could be a sign of cardiac arrest.

If you suspect cardiac arrest, immediately call for emergency medical assistance and begin cardiopulmonary resuscitation (CPR), use an automated external defibrillator (AED) if one is available, and continue until professional medical help arrives. Remember, quick action can make a life-saving difference in such critical situations.

On-Field Emergency Response

Football clubs and medical personnel should have well-established emergency response protocols in place to address cardiac arrest situations swiftly. Immediate recognition, early CPR, and rapid defibrillation are crucial in increasing the chances of survival. Coaches, players, and medical staff should be well-trained in CPR and the use of automated external defibrillators (AEDs) to respond effectively to a cardiac arrest.

CPR on adults

If you have been trained in CPR, including rescue breaths, and feel confident using your skills, you should give chest compressions with rescue breaths.

A defibrillator should be applied as soon as possible, and CPR should be continued in line with instructions from the AED.

If you’re not completely confident, attempt hands-only CPR instead.

Hands-only CPR

To carry out a chest compression:

  1. Kneel next to the person and place the heel of your hand on the breastbone at the centre of their chest. Place the palm of your other hand on top of the hand that’s on their chest and interlock your fingers.
  2. Position yourself so your shoulders are directly above your hands.
  3. Using your body weight (not just your arms), press straight down by 5 to 6cm (2 to 2.5 inches) on their chest.
  4. Keeping your hands on their chest, release the compression and allow their chest to return to its original position.
  5. Repeat these compressions at a rate of 100 to 120 times a minute until an ambulance arrives or for as long as you can.

CPR with rescue breathes

  1. Place the heel of your hand on the centre of the person’s chest, then place the palm of your other hand on top and press down by 5 to 6cm (2 to 2.5 inches) at a steady rate of 100 to 120 compressions a minute.
  2. After every 30 chest compressions, give 2 rescue breaths.
  3. Tilt the person’s head gently and lift the chin up with 2 fingers. Pinch the person’s nose. Seal your mouth over their mouth and blow steadily and firmly into their mouth for about 1 second. Check that their chest rises. Give 2 rescue breaths.
  4. Continue with cycles of 30 chest compressions and 2 rescue breaths until they begin to recover or emergency help arrives.

Reversible Causes of Cardiac Arrest

Cardiac arrest can be caused by various factors, and some of them are reversible if identified and treated promptly. Recognising the reversible causes is essential for improving the chances of survival and successful resuscitation. Healthcare professionals often refer to the “4 H’s and 4 T’s” to help remember the reversible causes of cardiac arrest:

4 H’s:

  1. Hypoxia: Insufficient oxygen supply to the body can lead to cardiac arrest. It may result from respiratory problems, airway obstruction, severe asthma attacks, or other conditions that hinder normal breathing.
  2. Hypovolemia: Severe blood loss or fluid depletion can cause a drop in blood volume, leading to reduced cardiac output and cardiac arrest.
  3. Hypothermia: Extremely low body temperature can slow down the heart’s electrical activity, leading to cardiac arrest.
  4. Hypo/Hyperkalemia: Abnormal levels of potassium in the blood can disrupt the heart’s electrical signals, leading to cardiac arrhythmias and potentially cardiac arrest.

4 T’s:

  1. Toxic Ingestions and Drug Overdose: Certain medications, toxins, or drug overdoses can interfere with the heart’s function and trigger cardiac arrest.
  2. Tension Pneumothorax: This occurs when air accumulates in the chest, putting pressure on the heart and preventing it from beating effectively.
  3. Cardiac Tamponade: In this condition, fluid or blood accumulates in the pericardium (the sac surrounding the heart), compressing the heart and hindering its ability to pump blood.
  4. Thrombosis (Pulmonary Embolism): A blood clot in the lungs can obstruct blood flow, leading to cardiac arrest.

When managing cardiac arrest, medical professionals and first responders must conduct a thorough assessment to identify and address these reversible factors promptly. By addressing the 4 H’s and 4 T’s, the chances of successful resuscitation and positive patient outcomes can be significantly improved. Early recognition and intervention for these reversible causes can make a critical difference in saving lives during emergency situations.

Risk Factors for Cardiac Arrest

Several risk factors can contribute to cardiac arrest, including underlying heart conditions, family history of heart disease, and previous heart-related incidents. Engaging in rigorous physical activity, such as high-intensity football matches, can also stress the heart, making it essential to identify players at higher risk and ensure their health is regularly monitored.

Emphasising Pre-Participation Screening

Preventive measures play a significant role in reducing the risk of cardiac arrest in football. Pre-participation screening, including medical history reviews and cardiac screening protocols, helps identify players who may be at risk of cardiac issues and ensures they receive appropriate medical clearance before taking the field.

Advancing Cardiac Safety in Football

Advancements in sports medicine and technology continue to enhance cardiac safety in football. Integrating wearable devices to monitor players’ heart rates, conducting regular heart screenings, and fostering a culture of open communication about health concerns contribute to safer playing environments.

Conclusion

Cardiac arrest is a rare but critical medical emergency that requires preparedness and vigilance in football. By understanding the risk factors, implementing preventive measures, and having robust emergency response protocols, football clubs and medical teams can create a safer environment for players.

Further Information

Football Association free course on Sudden Cardiac Arrest –https://learn.englandfootball.com/courses/medical/sudden-cardiac-arrest

Adult basic life support Guidelines – Adult basic life support Guidelines | Resuscitation Council UK

Disclaimer

The information provided in this article is for educational purposes only and should not substitute professional medical advice. Always consult with a qualified healthcare professional for diagnosis, treatment, and personalised recommendations based on your specific condition. Some affiliate links may also be used in this article, these are from products we have specifically selected to display based on our own experience.

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