[Management of cardiac arrest in a German soccer stadium. Structural, process and outcome quality].
BACKGROUND
In Germany there is a lack of data about the quality of emergency medical care in mass gatherings. The following report reflects our experience with management of cardiac arrest events as an example for the most critical medical emergency in a soccer stadium.


METHODS
The Fritz-Walter Stadium is a well-known soccer arena with a crowd capacity of 46,600. Emergency medical care is provided by a 2-tiered system consisting of 3 emergency physicians and 65 ambulance personnel and paramedics. Resuscitation was conducted according to the guidelines of the European Resuscitation Council and American Heart Association.


RESULTS
Within 80 months, 13 witnessed cardiac arrests occurred, all in males. In each case the initial rhythm was ventricular fibrillation, 6 patients collapsed before or after the match. Basic life support was usually provided within 2 min, defibrillation and advanced life support within 4 min, 77% regained spontaneous circulation, and 62% survived without neurologic deficits.


CONCLUSIONS
Cardiac arrest is a relatively frequent event in a soccer stadium. Due to a well organised response system, the survival rate exceeded by far the corresponding figures reported by public health systems.
Luiz
T
T
Institut für Anaesthesiologie und Notfallmedizin, Westpfalz-Klinikum GmbH, Hellmut-Hartert-Strasse 1, 67655 Kaiserslautern, Germany. tluiz@westpfalz-klinikum.de
Kumpch
M
M
Metzger
M
M
Madler
C
C
D016887:Cardiopulmonary Resuscitation; D004632:Emergency Medical Services / Q000458:organization & administration*; D004634:Emergency Medical Technicians; D005858:Germany; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians; D012916:Soccer; D013534:Survival; D000078329:Workforce