FIFA referees often attend a basic emergency medicine course prior to each FIFA competition and 5 June is the day for the 2018 FIFA World Cup™ officiators. The upcoming course is particularly significant, as this year, FIFA Medical aims to shine a spotlight on and raise awareness of sudden cardiac arrest (SCA).

SCA is a sudden failure of the heart to pump blood around the body when it unexpectedly stops beating regularly. It usually strikes without warning at anytime, anywhere, and can affect anyone, even if they appear healthy. Driven by the tragic death of Marc Vivien Foé, who suffered an SCA on the pitch during the FIFA Confederations Cup 2003, FIFA implemented a number of initiatives, including basic emergency medicine workshops for referees.

Referees are responsible for the health and safety of all players on the field of play. As time is critical, they must be able to recognise major life-threatening incidents on the pitch immediately and respond appropriately. The upcoming workshop will teach the World Cup referees how to recognise and respond to an SCA, including emergency steps, performing hands-only chest compression (CPR), and how to use an automated external defibrillator (AED).

As Efraim Kramer, FIFA Tournament Medical Officer for Russia 2018, said: “As an athlete, the FIFA referee himself is at risk of sudden cardiac arrest (SCA), but at the same time, he is the official in charge on the pitch and must therefore be able to manage an SCA incident, should it occur. It is therefore vital that all referees have a basic understanding of SCA in terms of recognition, response, resuscitation and removing the player from the pitch.”

The workshop will also instruct referees on how to identify other life-threatening illnesses and injuries that occur on the pitch, such as acute concussion. Topics will include the importance of removing players from active play, the “when in doubt, sit them out” policy, the FIFA three-minute timeout rule and the recently introduced medical video analysis replay.

Also covered will be heatstroke, a life-threatening neurological medical emergency that occurs when the environmental temperature and humidity are high enough to prevent players and referees from losing body heat. Details will be given on preparing for and implementing rest and cooling breaks, as well as on the use of the Wet Bulb Globe Temperature (WBGT) to monitor the match heat and potential risk to players.