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Cardiac arrests and sports – how we can minimise the damage

For many football fans, this weekend was an exciting time as the Euros were on and after a year of lockdowns, there have been limited matches to watch. However, the match between Denmark and Finland was not the viewing that many expected to see. Shortly before halftime, one of Denmark’s key players, Christian Eriksen, suddenly collapsed. It has since been reported that he had a cardiac arrest. 

The events unfolded like this (as reported in various media outlets such as the BBC):

Just before halftime, a throw-in was played towards Eriksen. He collapsed, and a number of his teammates ran to him to see if he was ok. One of these players was the Danish Captain, Simon Kjaer. Kjaer moved Eriksen into the recovery position, cleared his airways and began CPR. Meanwhile, other teammates who had rushed towards Eriksen called for the medics to get to the player as quickly as possible. Once they arrived, Kjaer stood back and led his teammates in creating a circle around Eriksen for privacy. The medics apparently initially found a pulse, but then lost this and subsequently had to begin CPR and use a defibrillator. They stated it required one attempt to restart Eriksen’s heart and at this point, transferred him to a stretcher and carried him off the  pitch

To sum up, TV cameras around the world captured a professional athlete with a high level of fitness have a cardiac arrest. It was a shocking and terrifying incident but also showcased how crucial action was and how without this, the outcome could have been very different. 

Given our background, we watched this story from a number of angles. As general spectators, a former paramedic and as first aid training providers. 

Here is what we think about what happened, broken down into more detail.

The medical response

Due to the speed that the emergency medical team took in recognising and treating the condition, the player will have the best chances of recovering from the cardiac arrest. As highlighted by the European Resuscitation Council and The Football Association, quick and definitive action is needed in the event of a person collapsing. In the event of cardiac arrest, the human body has roughly seven minutes of oxygen still in their system, so it is important to keep the flow of oxygen around the brain, heart and lungs by using cardiopulmonary resuscitation, or CPR for short.

As we can see from the actions of the referee and teammates, the first main issue is to identify that someone is in distress. The next key element is to ensure a first aid primary survey is completed, ensuring the casualty’s airway is open and checking if they’re breathing. The next and vital part of the process is to summon emergency support and begin the chain of basic life support.

It is always a challenge to look back at events and resolve whether everything was done as best as they could, however, the result is that the casualty is alive and currently recovering in hospital. What we can do is break down the main points and examine how they saved a young man’s life.

Quick recognition

Cardiac arrest is when the muscles of the heart fail to pump in co-ordination with itself, usually caused by a blockage in the arteries of the heart. When this happens, the muscle is starved of oxygen and begins to break and spasm. This is referred to as fibrillation. As the heart goes into this mode, oxygen doesn’t go to the brain and the vital organs begin to shut down. Shortly after this, the casualty will become weak, dizzy and begin to collapse. As the condition progresses, the brain shuts down, along with 

The casualty’s teammates and the referee quickly spotted what was wrong and called to attention the severity of the emergency. Play was stopped and a first aid team was called. Before their arrival, a teammate quickly examined the casualty and began to remove his mouth guard and secure his airway by tilting his head back. This would allow the first aiders to check if the casualty was breathing.

The primary survey

In first aid and first response, it is vital to assess whether the casualty is breathing, because this dictates the next actions. Once the first aid team realised that the casualty was not breathing, they started the chain of survival:

  • Call for emergency services or support – get the advanced life support team to the casualty as soon as possible, every second counts
  • Begin CPR – the faster the oxygen gets to the brain, heart and lungs, the quicker the casualty will begin to recover. Please be aware, this is NOT “saving the life” of the casualty, we are buying extra time till the medics can address the problem that caused the cardiac arrest and fix it
  • Automated external defibrillator – the automated system in the AED computes if a sharp, strong burst of electricity to the heart muscle will “reboot” the heart
  • Await the arrival of the emergency medical team – handover to them and tell them everything that happened

Once the chain of survival has started, there are just a few minutes to get through. It is important to complete all steps in order, as each one relies on the one before.

Automated External Defibrillator use is key to survival

When the medical team attached the AED, it ran a programme where it sends a small electrical signal through the casualty to detect a heartbeat. The device is programmed to spot when the heart is not working properly or is not working at all. Once the AED found a heart rhythm that didn’t work, the device told the responders to deliver a shock to the heart. All they needed to do was press a big flashing button and the AED did the rest.

All of the above points put together went on to save the casualty from dying, and when the doctors at hospital reviewed the casualty, they started the process of keeping the casualty alive. Not everything was done by the book, but the casualty is now safe and alive. Well done and congratulations to all that helped in the emergency!

The important thing to take away from this was that all the right equipment and training was available at the right time. Had even one of those things not been available, this incident could have looked a lot more different. As members of our community, we should ask ourselves:

What can we do to prepare for a cardiac arrest?

There are many ways that a community or organisation, whether it is a business or sports team, can safeguard against this danger. The most practical steps are:

  • Raise awareness of conditions that cause cardiac arrest – some are influenced by diet and exercise; some you are born with. Knowing the condition allows us to see what may trigger cardiac arrest
  • Learn CPR – as there is no warning for when the heart decides to go into cardiac arrest, we should be ready just in case. Learning the best way to deliver cardiopulmonary resuscitation (CPR) is an essential skill and means the difference of life and death
  • Know where your nearest AED is – finding the AED and getting it to the casualty as quickly as you can allows the AED to work most efficiently. A casualty does not have much time before the heart dies permanently, so restarting it is a priority

Learn how the emergency services can help when a casualty collapses – the local ambulance services are keen for people to communicate with them in an emergency, it is always a good idea to know what questions they will ask so you are ready with the answers

What Vital Workplace Training is doing to help the community

Starting in July 2021, Vital Workplace Training is rolling out programme of items to help the public deal with a cardiac arrest emergency:

A series of free CPR and AED training for the local communities in Coggeshall and surrounding areas, delivered from our new training room in Coggeshall

A member’s area on the website which features videos and resources that will provide a guide to many first aid emergencies

Free consultation for siting an AED in your community and subsidised pricing for AED packages

That’s not all; as a company, we provide training in all health & safety and first aid subjects, such as emergency first aid at work, parent first aid, fire safety, health and safety to name a few

If you would like to know more, feel free to contact me at dan@vitalworkplacetraining.com or 01376 317760.