Assessment of cardiovascular emergency care in sports venues: the Safety in Philippine Arenas for Cardiac Events Survey (SPACES)

Abstract Background Sudden cardiac arrest in athletes is an important public health concern and it has been shown that application of bystander cardiopulmonary resuscitation (CPR) and automated external defibrillators (AEDs) can improve outcomes. Data regarding availability and conduct of cardiovascular safety programs during sporting events in Southeast Asia is limited. Purpose To assess and compare the emergency response planning and sudden cardiac death preventative strategies between urban and provincial sporting venues in the Philippines. Methods An anonymized electronic survey was sent to individuals in charge of their cardiovascular medical response team for both competitive and practice games of their respective stadium/arenas where sports events are held. Included in the assessment were questions regarding AED training and availability, presence of medical personnel trained in CPR delivery during practice and games as well as availability of emergency medical action plans (MAP) and conduct during sports events. Results There were 37 respondents on behalf of their sports venues (78.7% response rate, 43% located in urban areas) who answered the survey. The medical team during games consisted predominantly of emergency medical technicians (86.5%) followed by nurses (59.5%), doctors (32.4%) and physical therapists (29.7%). No significant differences between urban and rural venues were noted aside from a significantly longer distance from rural venues to the nearest hospital compared to urban venues (mean of 4 kms vs 2.5 kms, p=0.02). AEDs were available in only 37.8% of venues with no significant differences between rural and urban arenas with regards to AED availability. While 70% of respondents claimed to have a MAP verbally, only 14 (38%) had a written MAP documentation available. Almost all medical staff had knowledge of basic CPR training (89%), however only 48.7% of respondents were trained in AED use. Ambulances were available mostly during sporting events (91.8%) but only 56.8% during practice games and 32.4% of venues employed the use of polyclinics/infirmaries during sporting events. Conclusions This study highlights current knowledge as well as critical gaps and inadequacies with regards to the delivery and provision of cardiovascular safety programs during sporting events in our setting. While CPR knowledge and staff availability appears adequate, improved access to training and availability of AEDs, mandatory CPR training and certification and availability of written medical action plans should be prioritized in the implementation, advocacy and policy making of relevant stakeholders to ensure adequate response to cardiac emergencies in sports for the safety of both athletes and spectators alike.CV Safety in Arenas and Stadiums