by Andrea Scapigliati
18 APR – Dear Director,
the sudden death on the football pitch of Mattia Giani, which occurred on Sunday 14 April 2024, fatally 12 years after that of Piermario Morosini, requires a reflection on the topic of aid for victims of cardiac arrest. The exact dynamics of the events are still being reconstructed, but his tragic death brings dramatic force back to the attention on what should be done in case a person who has lost consciousness and stopped breathing is rescued (the two identifying signs cardiac arrest): recognize the arrest, call 112, start chest compressions and apply the AED.
Tragic events like that of the two footballers reach public opinion more incisively but remind us that in Italy there are approximately 60,000 victims of sudden cardiac arrest every year (1 per 1000 inhabitants).
In our country a lot has been done both on a regulatory and awareness-raising level to combat this massacre of lives that can be saved by a few simple maneuvers.
Already in 2013, a few months after the emblematic death of Morosini, a state law required all sports clubs and associations to be equipped with an external defibrillator and trained personnel, still the only case in Italy of an obligation to equip it in a specific context. of activity.
Also in 2013, at the invitation of the European Parliament, the Italian Resuscitation Council launched “Viva! The week for cardiopulmonary resuscitation” which since then has been repeated every year around October 16th, which in the meantime has become World Resuscitation Day (World Restart a Heart Day).
Difficulties in involvement and governance had slowed down and weakened the application of the 2013 law (known as the Balduzzi Decree) with a 2017 decree which limited the obligation of the presence of the DAE to competitions and sports facilities only. However, the subsequent virtuous path of collaboration between parliamentary institutions, experts and associations led to the approval of law 116/2021 which incorporates all the most effective interventions to facilitate the prompt intervention of bystanders in collaboration with local emergency systems.
Law 116 reinstates the obligation to equip and share the AED both in competitions and in training but together with many other elements that make up a “system” around the victim capable of offering him the maximum chance of survival: the widespread diffusion of AEDs in crowded and travel places, the legal protection of the rescuer (very important to defuse fears of legal consequences), the possibility of using the AED even for those who have not been trained in its use (possibly with remote guidance from the operator of the 118), the location of AEDs and potential rescuers through a telephone application, the obligation for the 118 operator to guide the rescuer by telephone to carry out the maneuvers and use the AED, training and awareness initiatives in schools.
Despite this excellent law, Mattia’s death requires continuous reflection and tireless commitment. How can we prevent avoidable deaths (if they actually are avoidable)? First of all, committing to apply what is already foreseen and available.
Primary prevention (i.e. the mandatory medical examination for those who practice competitive sports but also strongly recommended for amateurs) remains a cornerstone for identifying those with an increased risk of cardiac arrest. However, if cardiac arrest occurs despite screening, it is necessary to be ready to recognize it and manage it immediately according to the indications that medical evidence has provided us with in a clear and appropriate manner for years now.
However, this does not just mean having the AED available: both in the case of Morosini and in the case of Giani (as it would seem at the moment), the AED was there but was not used. The diffusion and availability of AEDs must combine with a growing “rescue culture” which can only be created by raising awareness, informing and training: reassuring the rescuer’s responsibilities, creating motivation with correct information, facilitating communication with 112, providing information essential and encourage the acquisition of practical and lasting skills. All of this is all the more effective the earlier you learn. For this reason, education at school remains a fundamental hub for the creation of this culture; for this reason the involvement of sports institutions (another social training environment) must be convinced and supported; for this reason, places of work, coexistence and home must also include these routes.
Cardiac arrest is a dramatic and tragic event for the victim but also for those who assist and for the family and social context. Let’s not leave those who may be involved alone: let’s apply the rules, spread culture, save lives if possible.
Andrea Scapigliati
Presidente Italian Resuscitation Council (IRC)
April 18, 2024
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2024-04-18 08:46:49
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