Following on from our own superhero story, Pete Radford, we support the below statement from Super League Basketball’s Chief Medical Officer, Dr Amir Pakravan.
The British basketball community united in support recently of the young Cheshire Phoenix player who suffered a cardiac incident during a game in Basketball England’s youth pyramid.
I was very pleased to hear that the incident had been successfully managed by the coaches and individuals in attendance at the game and I would like to take this opportunity to both congratulate the team involved with the resuscitation effort and wish the player a speedy and smooth recovery.
The incident, like other well-known recent examples across the sporting landscape, once again brings Sudden Cardiac Arrest (SCA) in athletes to the fore so I wanted to take the opportunity to raise awareness about SCA and deliver some key messages to our athletes, clubs and the fans.
What is SCA?
- SCA occurs when the heart stops its normal function. Sadly, the event is the leading cause of death in athletes with more than half of cases proving fatal.
- Although SCA is relatively rare (0.9 – 1.8 cases per 100,000 people per year), its incidence in athletes can be 2.5–3.5 times higher than the general population. This is believed to be mainly due to significantly higher cardiovascular demands in athletes who may have an undiagnosed background cardiac issue.
What causes SCA?
- There are several possible causes for SCA but generally in athletes below 35 years of age likely causes include cardiomyopathies (heart muscle diseases), arrhythmias (abnormal heart rhythms), or structural/valve abnormalities.
- In athletes above 35 years of age, the primary cause is atherosclerosis (arterial plaque buildup).
What are the warning signs to watch out for?
More than half of athletes who suffer SCA report no previous cardiac symptoms. Warning signs to watch for include:
- Sudden, unexplained collapse during activity.
- Seizure-like movements in a normally healthy athlete.
- Not breathing or abnormal inefficient breathing during a collapse.
What steps should you take if somebody has an unexplained collapsed?
There may be various reasons for an individual to collapse, however, any unexplained collapse without contact or trauma in an otherwise healthy person without history of known reasons for possible collapse (such as uncontrolled diabetes, epilepsy, syncope, specific medication, …) must be treated as SCA until proven otherwise.
Immediate assessment can vary depending on an individual’s skills or availability of diagnostic equipment, but steps everybody can take are as follows:
- Check the patient’s responsiveness. If there is no coherent response, assess breathing (and check the patient’s pulse in the neck if you can).
- If breathing is abnormal or absent, start CPR.
- If alone, shout for help and contact emergency services before starting CPR.
What about defibrillators?
AEDs, or Automated External Defibrillators, can be found courtside at all Super League Basketball venues. Using one of these devices when attempting to resuscitate a patient of SCA can significantly increase chances of survival. AEDs are portable, easy to use, and guide users step-by-step through the process once attached to the chest.
How do you prevent SCA from occurring?
Although no tests can predict all SCA cases, SLB mandates that pre-participation screenings are undertaken by all clubs to reduce the risks.
The pre-participation screening generally consists of family and clinical history, physical examination and, depending on the circumstances, exercise tests and imaging such as echocardiogram or other advanced imaging. The combination is likely to pick up the majority of potential causes of SCA. There are various cardiac screening providers in the UK such as CRY (Cardiac Risk in the Young) which deliver this service, typically for the young active population and athletes between 14-35 years old.
We have implemented several additional mandatory requirements to try and reduce the risk of SCA or avoid a fatal outcome should SCA occur for an athlete at one of our games.
One of these measures is a requirement of all clubs to devise local Emergency Action Plans in preparation for such events. It is also mandatory to have an AED courtside for all training and game days, and clubs’ medical staff must be trained in delivering CPR.
There is always room for growth and improvement, and I welcome the opportunity for clubs and stakeholders collectively across the SLB to review our practices moving forward to further ensure the safety of everybody in our league and minimise potential risks in the future.
My general advice to fans, parents, athletes and those working in sports who may have questions or concerns about SCA is to think about screening, learn CPR and how to use an AED, and have a plan of action in the hopefully unlikely scenario that you may need to deal with a case of SCA in the future. Resuscitation Council UK webpage provides very useful information and resources for both medical professionals and general public. Basketball England has also recently set up a dedicated Cardiac information webpage with helpful resources.
Useful links:
Cardiac Risk in the Young (CRY): https://www.c-r-y.org.uk/
Resuscitation Council UK: https://www.resus.org.uk/public-resource/how-do-cpr
Basketball England Cardiac Information: https://www.basketballengland.co.uk/integrity/safeguarding/cardiac-information/
