Every football pitch in the world should adopt FIFA emergency medical care standard

Every football pitch around the globe should adopt a universal standard of emergency medical care, along the lines set out by FIFA, to curb the potential for serious injuries and deaths in the world’s most popular sport, urges an international panel of experts in the British Journal of Sports Medicine.

The call comes as FIFA moves to step up efforts to flag up the importance of dealing quickly and expertly with on-pitch medical emergencies, which although not common, are nevertheless a regular occurrence, particularly sudden cardiac arrest, which remains the leading cause of sudden death during play.

In recent years, there have been several high profile cases of sudden cardiac arrest, the most recent of which was Fabrice Muamba, who survived thanks to the prompt care given by a team physician who was part of the sideline medical team.

In a bid 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 Center has developed an emergency medical bag (FMEB), with the aid of an international panel of experts, made up of 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, which can be used anywhere in the world, at amateur and professional levels, 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 needs be.

And following a decision at the 2012 FIFA Congress, the FMEB has been sent to all 209 member associations of FIFA in June of this year.

In view of the varied knowledge, skills, training and composition of healthcare professionals on duty during training and competition, FIFA additionally 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 FIFA Medical Assessment and Research Center 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 and 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,” say the authors. “Education of the medical and paramedical staff, coaches, physiotherapists, referees and fitness trainers is an essential adjunct to this process,” they add.

“The FMEB is the proposed medical equipment standards to be provided at every football field and to be used whenever medical emergencies arise,” they conclude.