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Lesson from the story of Christian Eriksen: The Revised Utstein formula of survival

2022; Elsevier BV; Volume: 178; Linguagem: Inglês

10.1016/j.resuscitation.2022.07.016

1873-1570

Gian Domenico Giusti, Nicola Ramacciati,

Heart Rate Variability and Autonomic Control

About a year ago, the story of the Danish footballer Christian Dannemann Eriksen struck public opinion. It was a dramatic experience that touched millions of people worldwide as highlighted by Resuscitation.1.Barcala-Furelos R. González-Salvado V. Aranda-García S. Rodríguez-Núñez A. Cardiac arrest during broadcasted football match: The drama and the opportunity.Resuscitation. 2021; 167 (Epub 2021 Jul 21): 425-426https://doi.org/10.1016/j.resuscitation.2021.07.016Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar Today, the story of the thirty years old soccer player has transformed from a tragedy to a vital message about training effectiveness in cardiopulmonary resuscitation. The sudden collapse of the Danish midfielder is a stark remark of how a sudden cardiac arrest (SCA) can affect anyone, anywhere, and at any time.2.De Luca W. D’Alterio M. Baldini F. Baldi A. Christian Eriksen resuscitation: a warning.Ital J Emerg Med. 2022; 11: 32https://doi.org/10.23736/S2532-1285.21.00123-3Crossref Google Scholar However, the importance of early delivery of high-quality cardiopulmonary resuscitation (RCP) and early defibrillation - to obtain a rapid and prolonged return of spontaneous circulation (ROSC) that would increase the chances of survival from out-of-hospital cardiac arrest (OHCA) - was again highlighted after the recent success of the soccer player resuscitation. Indeed, thanks to an implanted defibrillator, the player could go back to playing at a professional level and score a goal for his National Team.3.Christian Eriksen scores on Denmark return - BBC Sport https://www.bbc.com/sport/football/60889501 (last access 31/03/2022).Google Scholar It's been ten years since, in Italy, a similar event with a different outcome occurred.4.Italy mourns footballer Piermario Morosini https://www.bbc.com/news/world-europe-17719098.Google Scholar The death of soccer player Piermario Morosini – died of a heart attack while he was playing a match in a professional championship – without the correct resuscitation maneuvers put in act is a warning for a formation not limited to medical personnel only. As a result of what happened, indignation has emerged - leading to the approval of a law that has established the obligation in all sporting events to have automatic external defibrillators (AEDs) and personnel trained in their use.5.Scapigliati A. Semeraro F. Di Marco S. Ristagno G. Italian Resuscitation Council Executive Committee. The new Italian law “A systems saving lives” the first European former application of ERC 2021 guidelines.Resuscitation. 2021; 167 (Epub 2021 Aug 10. PMID: 34384819): 47-48https://doi.org/10.1016/j.resuscitation.2021.08.003Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar The surge of public emotion in response to the sudden heart attack of Christian Eriksen can be used as an example to support the logic of CPR education.6.Fijačko N. Masterson Creber R. Štiglic G. Kocbek P. Skok P. Greif R. Public sentiment analysis of Twitter reaction on sudden cardiac arrest at EURO 2020.Resuscitation. 2021; 167 (Epub 2021 Jul 22): 427-429https://doi.org/10.1016/j.resuscitation.2021.07.018Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar In fact, these two episodes – the same cause but different outcomes – draw attention to the human factor. Images 1 A and B show two whole different situations. The operative confusion and the emotional chaos are apparent in Fig. 1 A. Whereas order and control reign in the European match (Fig. 1 B) - where the human barrier of the player has facilitated effective communication, situational awareness, leadership and team collaboration, task management, and decision making that put together with interpersonal and cognitive factors represent the human features that play a fundamental part in RCP.7.Greif R. Lockey A. Breckwoldt J. et al.European Resuscitation Council Guidelines 2021: Education for resuscitation.Resuscitation. 2021; 161 (Epub 2021 Mar 24): 388-407https://doi.org/10.1016/j.resuscitation.2021.02.016Abstract Full Text Full Text PDF PubMed Scopus (58) Google Scholar The control of said factors has probably been one of the elements that ensured the player's survival. Even though various studies have highlighted the importance of non-technical skills as a crucial element in resuscitation success, to date there is no scientific evidence on how to improve these soft skills.8.Greif R. Bhanji F. Bigham B.L. et al.Education, implementation, and teams: 2020 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations.Resuscitation. 2020; 156: A188_239https://doi.org/10.1016/j.resuscitation.2020.09.014Abstract Full Text Full Text PDF Scopus (48) Google Scholar A high-fidelity simulation can play an important role - but the main aspect that we want to point out is that in order to increase the chances of survival, it is of vital importance not only the Medical Science, Education Efficiency, and Local Implementation but also the ability to control the human factors in a sort of “revised Utsein formula of survival” (Fig. 1D). Gian Domenico Giusti: Conceptualization, Writing – original draft, Writing – review & editing. Nicola Ramacciati: Writing – review & editing, Supervision. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.