title: Acute cardiac events and deployment of emergency medical teams and automated external defibrillators in large football stadiums in the Netherlands.
abstract: BACKGROUND
  The incidence of acute cardiac events - including out-of-hospital cardiac arrest - may be increased in visitors of large sports stadiums when compared with the general population. This study sought to investigate the incidence of acute cardiac events inside large Dutch football stadiums, as well as the emergency response systems deployed in these stadiums and the success rate for in-stadium resuscitation.
  
  
  METHODS
  Retrospective cohort study using a questionnaire sent to the 20 Dutch stadiums that hosted professional matches during the 2006-2007 and 2007-2008 football seasons.
  
  
  RESULTS
  Stadium capacity ranged from 3600 to 51 600 spectators. Nearly 13 million spectators attended 686 'Eredivisie' (Honorary Division) and European football matches. All stadiums distribute multiple emergency medical teams among the spectators. Eighty-five percent of the stadiums have an ambulance standby during matches, 95% of the stadiums were equipped with automated external defibrillators (AEDs) during the study period. On an average, one AED was available for every 7576 spectators (range 1800-29 600). Ninety-three cardiac events were reported (7.3 per 1 million spectators). An AED was used 22 times (1.7 per 1 million spectators). Resuscitation was successful in 18 cases (82%, 95% confidence interval: 61-93).
  
  
  CONCLUSIONS
  The incidence of out-of-hospital cardiac arrest inside large football stadiums in the Netherlands, albeit increased when compared with the general population, is low. The success rate for in-stadium resuscitation by medical teams equipped with AEDs is high. Dutch stadiums appear vigilant in regard to acute cardiac events. This report highlights the importance of adequate emergency medical response systems (including AEDs) in large sports venues.
authors.affiliation: Department of Cardiology, Medical Center Alkmaar, Wilhelminalaan 12, Alkmaar, The Netherlands.
authors.forename: Femke
authors.initials: F
authors.lastname: van de Sandt
authors.forename: Victor
authors.initials: V
authors.lastname: Umans
mesh_terms: D000208:Acute Disease; D000552:Ambulances / Q000458:organization & administration; D016887:Cardiopulmonary Resuscitation; D047548:Defibrillators; D004554:Electric Countershock / Q000295:instrumentation*; D004631:Emergency Medical Service Communication Systems / Q000458:organization & administration*; D004632:Emergency Medical Services / Q000458:organization & administration*; D004634:Emergency Medical Technicians / Q000458:organization & administration*; D005160:Facility Design and Construction; D006323:Heart Arrest / Q000453:epidemiology / Q000628:therapy; D006331:Heart Diseases / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D015994:Incidence; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D012916:Soccer; D011795:Surveys and Questionnaires; D016896:Treatment Outcome