eriksen's collapse could have been so much worse
healthing.ca spoke to a sports medicine doctor about what it takes to keep athletes safe during major tournaments.
5 minute read
denmark's players react as paramedics attend to denmark's midfielder christian eriksen after he collapsed on the pitch during the uefa euro 2020 group b football match between denmark and finland at the parken stadium in copenhagen on june 12, 2021.
riedemann vogel/pool/afp via getty images
football fans in denmark and around the world were shocked last week when 29-year-old midfielder christian eriksen collapsed 43 minutes into the match.
team members rushed to eriksen’s side, rolling him onto his side to keep his airway open, then forming a human wall around the scene while the medical team assessed eriksen’s condition.
“he was gone,” morten boesen, the team doctor, later told reporters at a press conference. “we did cardiac resuscitation and it was cardiac arrest. how close were we [to losing him]? i don’t know but we got him back after one defib, so that’s quite fast.”
cardiac arrest is a health event where a person’s heart stops being able to pump blood effectively throughout the body. the heart relies on electrical impulses from the body’s pacemaker cells to develop a regular heartbeat, first pumping blood to the lungs where it is oxygenated and then pumping the oxygen-rich blood to the rest of the body. cardiac arrest can be caused by a host of factors, however, it most often occurs because the electrical system of the heart malfunctions, causing the heartbeat to become irregular and ineffective.
different abnormal heartbeats exist, however the ones most often quoted are ventricular tachycardia, where the heart is beating far to fast to effectively fill with blood to pump to the rest of the body, and ventricular fibrillation, where the muscles of the heart begin to quiver instead of contracting.
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later that day of the match uefa, the organization overseeing the euro 2020 football championship, confirmed via twitter that eriksen was stable in hospital. few details have been released about what caused eriksen’s collapse, although he has also reached out over social media to tell fans he is on the mend.
paramount to saving eriksen’s life was a well-trained and well-equipped medical team. within minutes of his collapse, the response team had started chest compressions and had applied a defibrillator, a device that delivers an electric shock to the chest with the aim of restoring a normal heartbeat. (quick application of a defibrillator can improve a patient’s chance of survival by 75 per cent, according to the heart and stroke foundation.)
morten went on to acknowledge the medical team and bystanders that assisted in their efforts.
“the team surrounding me and physio morten skjoldager, the pitch-side doctor, the stretcher team, the paramedics and the doping control officer, and of course, the players, who made a circle around us…made our working conditions optimal.”
medical teams on the sidelines
being prepared for different scenarios during a match is a considerable undertaking, explains cathy campbell, assistant professor of family and community medicine and president elect of the canadian association of sport and exercise medicine. medical teams must be ready for anything at a moment’s notice, often after long hours of sitting watching matches.
being prepared for different scenarios during a match is a considerable undertaking, explains cathy campbell, assistant professor of family and community medicine and president elect of the canadian association of sport and exercise medicine. medical teams must be ready for anything at a moment’s notice, often after long hours of sitting watching matches.
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“it’s not just knowing how to work a defibrillator, you have to have the whole team tuned up and ready to go after spending hours and hours and hours sitting watching matches,” she says. “part of the job of managing the medical team is keeping them up for long, long days, weeks, and so forth.”
campbell explains that training will start weeks before the tournament, where the medical team must get used to working with each other and learn the ins and outs of the particular pitch they are on. depending on the organizing body and the country the tournament is being held in, the team’s training and available equipment may differ. (according to uefa guideline, medical teams on the pitch must have access to a slew of specialized medical equipment, including “cardiac lifesaving drugs,” oxygen, and a defibrillator.)
“i always get there early on, like a dog with a bone,” says campbell. “i make [the medical teams] come out days ahead…we try all the different scenarios from having a knee injury to having a collapse on the field.”
she also spends time walking through the stands and the behind-the-scenes areas, trying to plan for every scenario — where to meet an ambulance if it’s needed, what happens if an evacuation is necessary and identifying safe places to set up medical equipment.
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and the job of a sports medical team isn’t just about learning how to respond, but also when to respond, as league rules specifically indicate when medical teams can rush onto the field.
interrupting the game without being signalled on by the referee can prove controversial, although some leagues, like fifa, have changed the rules so that medical teams can come to assist a player if they have collapsed without coming into contact with a player or the ball (which would indicate something is seriously wrong).
the incident calls to mind other football players who collapsed on the field, including marc-vivien foe, who died during the 2003 confederations cup in france, most likely due to lack of awareness of the need for speedy care.
sanjay sharma, professor of cardiology at st george’s, university of london, told bbc sport in 2013 that he was shocked to see the treatment foe received on the field.
“a player went down without any contact, his eyes rolled back, he had no tone in his body, so it was clear something terrible had gone wrong,” he said. “it took quite a while for the penny to drop that this was not going to get better with the magic sponge or fluid being poured on his head though.”
sharma also said in the interview that resuscitation should start within a minute and a half of someone going down, and for the defibrillator to be used within three minutes, to give the player a 70 per cent chance of staying alive. yet with foe, he said almost six minutes passed before attempts to restart his heart began.
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it was a sad day in fifa history, but foe’s death spurred changes to reduce the risk of cardiac arrest on the field, fifa’s chief medical officer jiri dvorak told bbc sport, with examinations of players before competition, training medical teams in cpr and using defibrillators, and having a plan if something happens. a shift that undoubtedly played an important role in eriksen’s survival.
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