Preventing sporting deaths

The Fédération Internationale de Football Association (FIFA), the world’s soccer association wants every major football pitch to adopt universal standards of emergency medical care

Football authorities across the world have been urged to adopt a universal standard of emergency care to help cut the potential for serious injury or death during matches.

Photo: Preventing sporting deaths
Photo: Preventing sporting deaths

A key part of the plan is an 11-step initiative devised by soccer’s international governing body the Fédération Internationale de Football Association (FIFA) Medical Assessment and Research Centre, which has also developed the FIFA 11-Steps to prevent Sudden Cardiac Deaths and other life-threatening situations.

Writing in the British Journal of Sports Medicine, an international panel of experts led by leading sports cardiologist Professor Jiri Dvorak, who is also FIFA’s chief medical officer, wants every major football pitch in the world to adopt a universal standard of emergency medical care along the lines set out by FIFA, to curb the potential for serious injuries and deaths.

The call comes as FIFA aims to step up efforts to flag the importance of dealing quickly and expertly with on-pitch medical emergencies. Although not common, such incidents continue to happen with sudden cardiac arrest remaining the leading cause of sudden death during play.

In recent years there have been several high profile cases of sudden cardiac arrest – among recent events was Fabrice Muamba during an English Premier League match, who survived thanks to the prompt care he received in the football stadium.

However, FIFA is anxious to boost the quality of the emergency field-side response and help medical teams provide a universal standard of potentially life-saving assistance.

FIFA’s Medical Assessment and Research Centre has developed an emergency medical bag (FMEB), helped by an international panel of experts, that included specialists in neurology, cardiology, orthopaedic surgery, sports medicine and emergency medicine.

The FMEB contains a comprehensive inventory of essential but generic equipment, accessories, and medicines – from dressings, syringes, and a stethoscope to a defibrillator and spinal board, for use anywhere in the world, at amateur and professional level, in training and competition.

The FMEB is designed to be used in response to a range of on-pitch medical emergencies, from anaphylactic shock and fractures, to spinal injuries and sudden cardiac arrest, for up to 60 minutes, if need be. Earlier this summer, following a decision at the 2012 FIFA Congress, the FMEB was sent to all 209 FIFA member’s associations.

In view of the varied knowledge, skills, training and composition of healthcare professionals on duty during training and competition, FIFA also recommends that key field-side professionals should go on FIFA football emergency medicine training courses, backed up with advanced life support/pre-hospital basic care qualifications.

As part of its prevention programme, the Centre has also developed the FIFA 11-Steps to prevent Sudden Cardiac Deaths (and other life threatening situations).

The 11-Steps protocol focuses on: prevention through screening to pick up athletes with pre-existing conditions that make them more susceptible to major injury or sudden death; planning through adequate training and an approved emergency medical plan; pre-game preparation to include the FMEB, an on-duty medical team, and an adequately staffed/equipped ambulance; putting the emergency medical plan into practice the moment a player collapses on the pitch.

‘Both the FMEB and FIFA 11-Steps are part of a broader preventive philosophy promoting player safety and football as a health enhancing leisure activity,’ the report authors explain. ‘Education of medical and paramedical staff, coaches, physiotherapists, referees and fitness trainers is an essential adjunct to this process…The FMEB is the proposed medical equipment standards to be provided at every football field and to be used whenever medical emergencies arise.’

FIFA’s Chief Medical Officer Professor Jiri Dvorak is a leading sports cardiologist at the Schulthess Clinic in Zurich, a leading European orthopaedic clinic with more than 13,000 surgical interventions annually and 40 interventions performed daily. The clinic strongly relies on multidisciplinary teams representing different medical specialties. The clinic is home to the FIFA Medical Centre of Excellence and the FIFA Medical Assessment and Research Centre F-MARC, of which Professor Dvorak is chair.


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