Event and sideline management of sudden cardiac death

The increasing use of automated external defibrillators (AEDs), coupled with methods to improve cardiopulmonary resuscitation and implementation of early defibrillation, have significantly improved survival from sudden cardiac death (SCD) in the prehospital setting. This article reviews the evidence and principles of management of SCD in the sports setting. It is noted that ventricular fibrillation is the most common arrhythmia causing SCD in athletes. When it occurs, survival is reduced by 7% to 10% per minute pending defibrillation. This statistic is true for athletes as well as nonathletes, and underscores the critical need for a rapid defibrillation response. Use of the AED in the sports setting and suggestions on whether to implement an AED program are reviewed. Despite increasing application of this technology, outcomes data on the use of AEDs in the sports arena are lacking, partly due to the relatively rare occurrence of SCD therein. New evidence on pharmacotherapy in SCD is also reviewed. Although drug administration in SCD is unlikely to be required in the sports setting, clinicians are updated on some of the newer considerations. Finally, selected articles from the recent literature on advanced cardiac life support are provided to guide the team physician in using the most current approach to the management of SCD.