Background Sudden cardiac arrest (SCA) during sports can be the first symptom of yet undetected cardiovascular conditions. Immediate chest compressions and early defibrillation offer SCA victims the best chance of survival, which requires prompt bystander response.Aims To determine the effect of rapid bystander response to SCA during sports by searching for and analyzing videos of these SCA/SCD events from the internet.Methods We searched images.google.com, video.google.com and YouTube.com, and

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... included any camera-witnessed non-traumatic SCA in athletes and other sports participants at any sports facility. The rapidity of starting bystander chest compressions and defibrillation was classified as <3, 3-5, or >5 minutes. The year SCA occurred was allocated to 1990-2009, 2010-2014 or 2015 onwards, compatible with the current guidelines.ResultsWe identified and included 28 victims of average age 27.9 years (SD=9.8); 27 were males, 22 elite athletes, and 17 participated in soccer. Bystander response <3 minutes (6/28) or 3-5 minutes (1/28) and defibrillation <3 minutes was associated with 100% survival. Not performing chest compressions and defibrillation was associated with death (14/28), and >5 minutes delay of intervention with worse outcome (death 4/28, severe neurologic dysfunction 1/28). Survival was highest between 2010-2014 (71.4%).ConclusionsAnalysis of internet videos showed that immediate bystander response to non-traumatic SCA during sports was associated with improved survival. This suggests that immediate chest compressions and early defibrillation are crucially important in SCA during sport, as they are in other settings. Optimal use of both will most likely result in survival. The observed bystander responses to SCA during sports do not show awareness of current guidelines.