Enhancing Emergency Response In Community-based Sports: Sugadaira Aed For Everyone (safe) Project

Hundreds of school and community-based rugby teams around Japan come to Sugadaira, Nagano, during the summer months for training camps. The area is rural and sparsely populated, with an average emergency medical service response time of 30 minutes. Only 4 of 108 athletic fields in Sugadaira had access to an automated external defibrillator (AED), which posed a significant challenge to the emergency response in the area. In 2021, a student-athlete experiencing cardiopulmonary arrest was successfully resuscitated, attributed to the event occurring at one of the four fields equipped with an AED. PURPOSE: Propose a community-based AED program to enhance sports medicine and emergency response in a rural town in Japan during the period of over-tourism by school-organized rugby training camp users. METHOD: The Sugadaira AED for Everyone (SAFE) project, conducted from 2022 - 2024, prepared and made available 274 (2022, n = 105; 2023, n = 86; 2024, n = 83) portable AEDs during the respective rugby training camp seasons in 2022 (7/8-9/5), 2023 (7/13-9/11), and 2024 (7/12-9/9). AEDs were made available through the support of the Japan Rugby Football Union (JRFU funded costs during 2022 - 2023 season) and the local athletic field union (funded 50% along with JRFU [50% match]) during 2024 season. A cost analysis of the AED rental fee was conducted to assess its sustainability. RESULT: AEDs were accessible to 595, 878, and 909 teams in 2022, 2023, and 2024, respectively. No cardiopulmonary arrest cases were documented during the study period. The total cost of supporting the portables AEDs to be made available onsite was 4,383,000 yen, with an average cost of 1951 ± 758 yen per team per training camp stay. CONCLUSION: This case study provides valuable insights for establishing a community-based sports medicine framework in rural regions with pre-identified high-demand seasons. Although the SAFE program was fully funded by the JRFU and local athletic field union during the study period, our findings indicate that the associated costs could be feasibly distributed among teams staying in Sugadaira with minimal financial impact. The current cost analysis may support the implementation of a sustainable per capita infrastructure fee to enhance emergency preparedness in Sugadaira that does not rely on unsecured funding from organizations. Supported by: The project was funded by Japan Rugby Football Union.