When Someone Collapses on the Pitch

Not every cardiac arrest looks the way we expect. One of the more nuanced additions in the 2025 resuscitation guidelines deals with two scenarios that don't fit the classic picture of "someone collapsed and isn't breathing": cardiac arrest during sport, and cardiac arrest that happens alongside a traumatic injury. Both are genuinely useful for anyone who teaches or works in outdoor, sports, or physically active settings.

Cardiac arrest in sport

If someone collapses during, or immediately after, physical activity, the updated guidance is to assume cardiac arrest and act accordingly. This might sound like an odd thing to need to spell out, but in practice, a collapse during sport is often first read as exhaustion, dehydration, or a minor injury — especially in younger, apparently fit individuals, where cardiac arrest doesn't fit the mental picture people have of "who this happens to."

That assumption can cost precious time. The new guidance is deliberately blunt about it: treat a sporting collapse as a possible cardiac arrest until proven otherwise, check responsiveness and breathing immediately, and be ready to start CPR and call for an AED without delay. Sports coaches, PE staff, activity leaders, and outdoor instructors are exactly the audience this update is aimed at — the people most likely to be first on the scene when this happens.

Traumatic peri-arrest and cardiac arrest

The second addition is more technical, but just as important for anyone working in environments where injuries are a real possibility — outdoor education, adventure sports, construction, or anywhere physical risk is part of the setting. The guidelines introduce a new protocol for what's called traumatic peri-arrest: situations where a casualty is deteriorating towards cardiac arrest as a result of a traumatic injury, rather than a purely cardiac event.

In these situations, rescuers may need to give CPR while simultaneously treating the traumatic injury causing the deterioration — for example, controlling severe bleeding at the same time as starting compressions, rather than treating the two as separate, sequential problems. This is a meaningful shift in thinking for anyone trained primarily in "classic" CPR scenarios, where the cause of arrest is assumed to be cardiac rather than traumatic.

Why this matters for outdoor and sports-focused training

These additions are a good reminder that first aid isn't one-size-fits-all — the right response depends heavily on context. A generic workplace first aid course, built around an office environment, doesn't naturally prepare someone for a collapse on a rugby pitch or a fall on a mountainside. If you deliver first aid training in a sports, outdoor, or physically active context, these updates are directly relevant to your learners in a way that goes beyond ticking a compliance box.

Practical takeaways for instructors

• Build sport-specific and trauma-specific scenarios into your practical sessions, rather than relying solely on generic "person collapses in a room" simulations.

• Explicitly teach the instruction to assume cardiac arrest after a sporting collapse — don't leave learners to infer it.

• Walk through the logic of treating trauma and cardiac arrest simultaneously, so learners understand it's a "both, not either" situation rather than a strict sequence.

Context changes everything in an emergency. These updates exist because real-world cardiac arrests don't always look like the textbook version — and good training should reflect that.

Prepare your team for the scenarios they'll actually face

If you coach, teach, or lead activities where sport or trauma-related emergencies are a real possibility, generic first aid training may not be enough. Basecamp First Aid offers scenario-based training tailored to sports and outdoor contexts.

Talk to us at basecampfirstaid.com or email info@basecampfirstaid.com to discuss training for your team or group.

Disclaimer: This article is for general information and educational purposes only and does not constitute medical advice. It reflects a summary of the Resuscitation Council UK 2025 Guidelines as understood at the time of writing; guidance may be updated, and implementation timelines can vary between awarding bodies and training providers. Always follow the specific instructions of your first aid course provider and the current guidance of the Resuscitation Council UK (resus.org.uk). In a real emergency, always call 999 (or your local emergency number) immediately.

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