What measures can sports clubs take to reduce the incidence of Sudden Cardiac Death
Professional scientific societies from Europe and the USA provide a number of clear recommendations regarding competitive athletes with 2 major goals. The first goal is to screen participants before they engage in competitive sports to identify those who are at higher risk of SCD. The second goal is to establish emergency action plans that are capable of dealing with SCD events that happen on the fields.In terms of pre-participation screening, clubs can help by referring their participants to experienced physicians for a pre-participation medical check-up. The scientific societies provide a clear list of questions that should be asked during history taking and a list of physical examination items to guide the physicians performing preparticipation screening. In addition to obtaining history and examining patients, health care professionals can also obtain electrocardiograms, which have the potential to detect some of the underlying heart abnormalities that we listed above. It is of paramount importance that heart specialists who are experienced in the field of sports medicine interpret those electrocardiograms. Sub-optimal interpretation of such tests can unfortunately falsely reassure individuals who have heart disease or generate unnecessary anxiety and unnecessary additional testing in individuals who are healthy. In fact athletes can have a variety of unusual but benign findings on their electrocardiograms that only reflect normal changes in the heart related to physical conditioning. While there is a general consensus among scientific societies that pre-participation history and physical exam are indicated in all athletes, implementing routine electrocardiogram screening in all young athletes remains more controversial because of the pitfalls that we have mentioned. As for establishing emergency action plans, clubs should ensure they have multiple available personnel who are trained to respond to cardiac arrest situations. This includes performing adequate cardiopulmonary resuscitation (CPR) and utilizing automated external defibirllators (AED). It is paramount that clubs should have easy access to AED in the immediate vicinity (within a 3 minutes walk) from their sports fields. Those AED should be maintained properly charged at all times and their function should be tested regularly based on manufacturer guidelines. Clubs should practice and review their emergency plans at least annually and should collaborate closely with the local emergency medical services to make sure their fields are easily accessible to emergency medical first-responders and vehicles in case of emergencies.