1. Access to early defibrillation is essential. A goal of less than three to five minutes from the time of collapse to delivery of the first shock is strongly recommended.
  2. Pre-participation physical examinations should include completion of a standardized medical history form and attention to episodes of exertional syncope or pre-syncope, chest pain, a personal or family history of sudden cardiac arrest (SCA), and exercise intolerance.
  3. SCA should be suspected in any athlete who has collapsed and is unresponsive. A patient’s airway, breathing, circulation and heart rhythm (using an AED) should be assessed. An AED should be applied as soon as possible for rhythm analysis.
  4. Myoclonic jerking (brief, involuntary twitching) or seizure-like activity is often present after collapse from SCA and should not be mistaken for a seizure. Occasional or agonal gasping should not be mistaken for normal breathing.
  5. Cardiopulmonary resuscitation should be provided while the AED is being retrieved, and the AED should be applied as soon as possible. Interruptions in chest compressions should be minimized by stopping only for rhythm analysis and defibrillation. Treatment should proceed in accordance with American Heart Association guidelines.1


  1. Casa DJ, Guskiewicz KM, Anderson SA, et al. National athletic trainers’ association position statement: Preventing sudden death in sports. J Athl Train. 2012;47(1):96–118.