Intended for healthcare professionals

Rapid response to:

Letters Field of play resuscitation

Do not move player requiring resuscitation on field until return of spontaneous circulation

BMJ 2012; 344 doi: (Published 02 April 2012) Cite this as: BMJ 2012;344:e2448

Rapid Response:

Re: Do not move player requiring resuscitation on field until return of spontaneous circulation

Drs Lyon and Wiggins illustrate a vital aspect of Sudden Cardiac Arrest (SCA) management on the sports field. Effective chest compressions, with minimal interruption, keeps the player alive until and between AED defibrillation shocks, if and when necessary. However, one cannot remain on the field of play for extended periods, and it is therefore part of the resuscitation process that an ambulance be brought onto the field to transfer the player off the field or that a decision be made to expiditiously remove the player off the field if ambulance access is not possible.Such transfer should be undertaken on a rigid type stretcher under all circumstances, so that effective continuation of chest compression can resume immediately after transfer actions, whether at the side of the field or in the back of the ambulance, as part of the process of moving the player to the stadium medical centre or nearest most appropriate emergency department.

Ambulance transfer of a player in SCA, with full chest compressions and intermittent AED defibrillation, if and when necessary, is a vital aspect of this type of resuscitation and is contrary to the wide held view that pulseless patients should not be transported to hospital emergency departments with en route CPR and AED use.Therefore it is mandatory that medical crews providing medical standby services at sport events be adequately trained in these sport-related resuscitation modifications if the player in SCA is to be affored the greatest chance of survival back to normality.

Competing interests: No competing interests

30 July 2012
Efraim B Kramer
Emergency Physician / FIFA Medical Officer
Witwatersrand University
York Road, Parktown, Johannesburg, South Africa