Christian Eriksen's sudden collapse on the field during Denmark's Euro 2020 encounter against Finland had the world reeling on what could only be described as the most harrowing on-screen sports experience in recent times.
As we sat with bated breath and dread on what may unfold, news of Christian having gained consciousness and being stable was received with a sigh of relief. This happened thanks to the timely decision of the referee and his team members to call the medical team in and start treatment minutes after the Danish star collapsed to the field, eyes agape shortly before halftime.
What followed was a brilliant and timely effort of the medical team seen giving CPR (cardiopulmonary resuscitation) to the player.
So what may have happened during those crucial minutes that ended the fateful evening positively?
Could the outcome have been completely different had there been a few moments delay?
What is Cardiopulmonary Resuscitation and how does it work?
Reports suggest that Eriksen received CPR after his collapse due to fear of him having suffered a cardiac arrest, where the heart stops beating and is unable to pump blood to the body.
Cardiopulmonary resuscitation is a life-saving procedure used in emergencies as a part of basic life support (BLS) which in addition also includes early detection of sudden cardiac arrest (SCA) which was the case for Eriksen, heart attack, stroke, and foreign-body airway obstruction (FBAO); and defibrillation with an automated external defibrillator (AED).
Cardiopulmonary resuscitation comprises 3 steps: circulation i.e. chest compressions, airway, and breathing (CAB), to be performed in that order in accordance with the 2010 American Heart Association (AHA) guidelines.
In the event of an emergency, the medical team will investigate whether the victim is conscious or not, followed by checking the pulse which is done for no more than 10 seconds.
The CPR further involves the following —
Chest compressions are the first to be initiated in the ratio of 30:2 (30 compressions followed by 2 rescue breathes) till the time the victim is resuscitated or the AED arrives. These require extreme precision and skill on the part of the rescuer.
In the next step, the airway is opened by positioning the victim on their back. The head tilt with chin lift manoeuvre is used to open the airway and deliver the breaths in between the chest compressions.
In the third step, breathing is checked by looking at the chest for respiratory movements, listening at the victim's mouth for breath sounds and feeling for air on the cheek for no more than 10 seconds. If the victim is breathing normally but is unresponsive, he is turned into the recovery position which is how Christian was moved.
The fourth step in CPR is the use of an Automated External Defibrillator which when attached, detects the heart rhythm and delivers a direct current electric shock when needed. Attempting defibrillation is vital because each minute of delay decreases the chance of successful resuscitation by about 3-5%. Once the normal heart rhythm is restored, the return of spontaneous circulation is expected.
The final steps post defibrillation include Advanced Resuscitation, post-cardiac arrest care, and recovery.
Post-resuscitation care then includes the identification and treatment of the cause of cardiac arrest, airway and ventilation management, hemodynamic management, targeted temperature management, glycemic control, and finally seizure or neural management if required.
In any sporting event, such emergencies are expected to occur although they are very rare. Nonetheless, the medical team is always prepared with an emergency action plan to tackle such situations in collaboration with the emergency services personnel, team physicians, physiotherapists, trainers, etc.
Thus, the timely efforts of the medical team helped in saving Christian's life in the few moments where football was forgotten and the whole world prayed together as one.
(Dr. Mamata Revankar is a sports physiotherapist who has been dealing with athletes from different sports like golf, cricket, tennis, badminton, etc on a regular basis for injury prevention and performance enhancement. She dabbles in medical writing as a passion.)