The following elements of a comprehensive emergency action plan (EAP) for sudden cardiac arrest (SCA) in athletics were recommended by an intra-association task force. Actual requirements and implementation may vary depending on the location, school or institution.

  1. Development of an Emergency Action Plan
    • Establish a written EAP for each individual athletic venue.
    • Coordinate the EAP with the local EMS agency, campus public safety officials, on-site first responders, administrators, athletic trainers, school nurses and team and consulting physicians.
  2. Integrate the EAP into the local EMS response.
    • Determine the venue-specific access to early defibrillation (<3–5 minutes from collapse to first shock recommended).
  3. Emergency Communication
    • Establish an efficient communication system to activate EMS at each athletic venue.
    • Establish a communication system to alert on-site responders to the emergency and its location.
    • Post the EAP at every venue and near telephones, including the role of the first responder, a listing of emergency numbers, street addresses and directions to guide EMS personnel.
  4. Emergency Personnel
    • Designate an EAP coordinator.
    • Identify who will be responsible and trained to respond to a SCA (likely first responders include athletic trainers, coaches, school nurses and team physicians).
    • Train targeted responders in CPR and AED use.
    • Determine who is responsible for personnel training and establish a means of documentation.
    • Identify the medical coordinator for on-site AED programs.
  5. Emergency Equipment
    • Use on-site or centrally located AED(s) if the collapse-to-shock time interval for conventional EMS is estimated to be >5 minutes.
    • Notify EMS dispatch centers and agencies of the specific type of AED and the exact location of the AED on school grounds.
    • Acquire pocket mask or barrier-shield device for rescue breathing.
    • Acquire AED supplies (e.g., scissors, razor and towel) and consider an extra set of AED pads.
    • Consider bag-valve masks, oxygen delivery systems, oral and nasopharyngeal airways and advanced airways (e.g., endotracheal tube, Combitube or laryngeal mask airway).
    • Consider emergency cardiac medications (e.g., aspirin, nitroglycerin).
    • Determine who is responsible for checking equipment readiness and how often, and establish a means of documentation.
  6. Emergency Transportation
    • Determine transportation route for ambulances to enter and exit each venue.
    • Facilitate access to SCA victim for arriving EMS personnel.
    • Consider on-site ambulance coverage for high-risk events.
    • Identify the receiving medical facility equipped in advanced cardiac care.
    • Ensure medical coverage is still provided at the athletic event if on-site medical staff accompanies the athlete to the hospital.
  7. Practice and Review of EAP
    • Rehearse the EAP at least annually with athletic trainers, athletic training students, team and consulting physicians, school nurses, coaches, campus public safety officials and other targeted responders.
    • Consider mock SCA scenarios.
    • Establish an evaluation system for the EAP rehearsal and modify the EAP if needed.
  8. Post-Event Catastrophic Incident Guidelines
    • Establish a contact list of individuals to be notified in case of a catastrophic event.
    • Determine the procedures for release of information, aftercare services and the post-event evaluation process.
    • Identify local crisis services and counselors.
    • Consider pre-established incident report forms to be completed by all responders and the method for system improvement.1


1. Drezner JA, Courson RW, Roberts WO, et al.Inter-association Task Force recommendations on emergency preparedness and management of sudden cardiac arrest in high school and college athletic programs: a consensus statement. J Athl Train. 2007;42(1):143–158.