This blog examines FIFA’s new approach to medical emergencies in football – the “Medical Set Piece.” Just like rehearsed free kicks, FIFA have created a standardised emergency protocol where medical teams practice coordinated responses until they become automatic. Here, we explore the Pre-match Emergency Action Plan (PEAP), which assigns colour-coded roles to team members, ensuring consistent emergency care across all levels of football worldwide. By treating medical emergencies like choreographed set pieces, this system reduces confusion and human error when lives are on the line.

In football terminology, a ‘set piece’ is a scripted and rehearsed response to a challenging situation, for example, a free kick. The FIFA Medical Set Piece borrows this term to describe the optimal preparation for an emergency where a team continues to practice for a predicted scenario, with each member designated a clearly defined role until the coordination of these roles is ideal. Set-piece thinking permits optimal team performance by allowing each individual to remain task-focused without distraction. 

To support and promote a consistent level of emergency medical care on the football field globally and reduce human errors regardless of the resources available, the Fédération Internationale de Football Association (FIFA) proposed a standardised protocol for medical teams managing emergencies in sport: the Pre-match (training) Emergency Action Plan (PEAP). This has now been updated to improve clarity and promote adaptability to all levels of football. It is understood that the availability of people with basic life support (BLS) training will vary between clubs as well as within organisations, so having a predetermined plan in place to account for these differences is paramount. The actual clinical framework of how you deal with a presentation of collapse or injury will always be the same but what might differ are the number of people available to help make the best assessments and apply the best treatment. To achieve the best outcome, every team, whatever its composition, needs to assign clear roles and then rehearse. 

The assessment of a player who has collapsed or sustained an injury needs to be structured and consistent (a rehearsed Medical Set Piece). Regardless of whether a player requires medical attention during training, a warm-up session or a match, having a framework that can be applied in the same way each time will help to ensure the best outcomes.  But we are only ever as strong as the weakest link in the chain, which is why we need to train every team member in their role until we and they are confident to perform it reliably.

Planning and rehearsing is therefore a key element in reducing human error and ensuring that the chain is kept at its strongest. The PEAP illustrates a process by which people attending matches/training organise themselves to deliver prioritised care in emergency scenarios by rehearsing their individual roles over and over, within a team setting. By linking key clinical interventions with predetermined roles, the PEAP helps teams manage the challenging human factors inherent in an emergency on the field of play. This latest version of the PEAP focuses on each person’s pre-determined specific role that involves only one task at a time.

A name should be written on the PEAP alongside each of the tasks, and it should be clear to each individual what their responsibilities are. The team leader should ascertain that each team member is capable of performing their role. The PEAP now offers more clarity on each role’s tasks, creating more simplicity and lessening the chance of errors. The new role cards enforce the colour coding used in the PEAP. Given to each member, they offer definitive assignments for each possible scenario, that can be referenced at any time, to aid in both learning and task deliverance. 

The aim of the PEAP and the role cards (developed in multiple languages) is to build on this understanding of roles and to introduce other important details, such as where each person should be positioned when attending to a player. Apart from physical obstructions such as goalposts or advertising hoardings, each role within the pitch-side team takes up exactly the same position in relation to the injured player each time they enter the field of play to:

• minimise any confusion over where each person should be;
• minimise the chances of people getting in each other’s way;
• make the extrication more efficient; and
• inspire confidence in the team among those watching on as well as among the players themselves.

To complete the FIFA Medical Set-Piece toolkit, we have developed life support algorithms that, while building on universally agreed approaches, emphasize the individual colour-coded tasks of each role within the PEAP. This offers a visual resource focusing on the overall aim of providing a safe and effective approach to a scenario, separating the tasks within each role, providing an easily digestible framework at each stage of managing an emergency on the football pitch.

We hope the newest version of the FIFA PEAP and the supporting toolkit fundamentally become a scripted medical response that reduces the complexity of lots of moving pieces all working together in a predictable, synchronised manner. The clarification and colour-coding of each member’s role simplify and reduce the probability of interfering with other members’ work, thereby  enabling its use globally, at all levels of the game. When rehearsed regularly, this will result in the best response and outcome. 

Take home messages: The FIFA Medical Set Piece

• Rehearse to save lives: Regular practice of emergency protocols transforms chaos into coordinated response. Teams must drill scenarios until reactions become automatic.
• Clear roles prevent confusion: Colour-coded, single-task assignments ensure everyone knows exactly what to do and where to position themselves during emergencies.
• Simple systems work everywhere: A standardised approach adapts from grassroots to professional levels, ensuring consistent care quality regardless of available resources.
• Practice makes perfect: Regular team rehearsals eliminate the weakest links and build the confidence needed for life-or-death situations.

The Medical Set Piece proves that systematic preparation and clear roles can transform emergency response from reactive chaos into reliable, life-saving teamwork.

Authors: 

• Andrew Massey, Medical Department, Federation Internationale de Football Association, Zurich, Switzerland 
• Jonny Gordon, Medical Department, Scottish Football Association, Glasgow, UK
• Katharina Grimm, Medical Department, Federation Internationale de Football Association, Zurich, Switzerland