EMERGENCY RESPONSE PROTOCOLS ESSENTIAL FOR SUDDEN CARDIAC ARREST AT SPORTING EVENTS

By V.Sankara

KUALA LUMPUR, July 16 (Bernama) -- Written and visible emergency response protocols at sporting events are essential to ensure all personnel are prepared to act swiftly in the event of sudden cardiac arrest involving young athletes, a cardiac rehabilitation specialist said.

Assoc Prof Dr Hashbullah Ismail of Universiti Teknologi MARA (UiTM), Exercise Physiology Lab & Exercise Rehabilitation, Faculty of Sports Science and Recreation emphasised the importance of having at least one team member trained in formal first aid and cardiopulmonary resuscitation (CPR) at all sporting events. 

“Immediate activation of local emergency medical services (EMS) should not be delayed, and early communication is vital. A working phone must be available onsite at all times.

"All personnel must be fully aware of the necessary steps to take if an incident occurs. Anticipation and thorough preparation, including training, personnel, and equipment, are crucial.

“Proper preparation can make the difference between life and death," he told Bernama, noting that there were numerous cases of social badminton players collapsing on court and dying over the years, the most recent being Chinese player Zhang Zhijie.

In what could be considered the first on-court casualty in badminton, 17-year-old Zhang collapsed on the court during the 2024 Badminton Asian Junior Championship in Yogyakarta, Indonesia on June 30.

He was pronounced dead on arrival at the hospital, with the cause of death believed to be cardiac arrest. A huge controversy erupted following his death, especially over the time it took for the medical team on duty at the tournament to administer first aid.

Dr Hashbullah also stressed the need for a designated individual proficient in primary airway management.

"If necessary, a practitioner skilled in advanced cardiac and trauma life support (ACLS/ATLS) should be present at the event," he said, adding that specific equipment was crucial in such emergencies.

"An automatic external defibrillator (AED) and airway and ventilation adjuncts are essential tools that can help save lives," he said.

Dr Hashbullah also noted that the most common cause of sudden cardiac arrest in young athletes is hypertrophic cardiomyopathy (HCM), accounting for 36 per cent of deaths in one study.

"HCM is a disease characterised by hypertrophy of cardiac muscle (big heart muscle) without dilation of the left ventricle (bottom left of the heart muscle)," he explained.

When asked about preventive measures sports organisations could implement to reduce the risk of cardiac arrest among young athletes, Dr Hashbullah said it is necessary for sports organisations, event organisers, and schools to obtain informed consent from the young athletes’ families.

“The informed consent must include important information from the family on their children's health status, such as personal health history related to chest pain and family history of premature sudden death.

“Those with a high-risk history should undergo a physical examination at a hospital or health centre before participating in vigorous and high-intensity activities. This will create awareness and is an important preventative measure to reduce the risk of cardiac arrest," he said.

Dr Hashbullah, who is also Head of the Asia College of Exercise Medicine (ACEM) Medical & Rehabilitation Centre at Damansara Damai, Selangor, added that it is compulsory to conduct a pre-participation physical evaluation (PPE) consisting of health questionnaire and physical examinations, which is important for competitive young athletes.

-- BERNAMA