Buffalo, N.Y. (WBEN) - The football community and the rest of the sports world continues to digest the events that unfolded Monday night in Cincinnati when Buffalo Bills safety Damar Hamlin suffered a cardiac arrest on the playing field.
After making, what seemed to be, a routine tackle of Bengals wide receiver Tee Higgins with less than six minutes left in the first quarter, Hamlin got up from the play and then suddenly collapsed to the turf.
Medical personnel from the Bills and other medical professionals on-hand for the game immediately went to work on Hamlin after he became unresponsive, administering CPR and using an AED machine to get his heartbeat restored on the field.
Following several minutes of work to revive Hamlin, medical personnel was able to load Hamlin on an ambulance to transport him to the University of Cincinnati Medical Center. There, he was sedated by doctors and listed in critical condition while undergoing additional tests and treatment in the intensive care unit.
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Without the quick work of trainers and other doctors and personnel at Paycor Stadium on Monday night to administer CPR to Hamlin, the outcome could have been even more tragic.
"We saw it [Monday] night - as someone who's done CPR countless times in every situation whether it's in somebody's home, in a hospital, even a jail cell, I've performed CPR - it's always tragic, it's always hard to watch, it's always hard to be a part of it," said Roger Leising from WNY Health Education and Equipment, as he called in to David Bellavia on WBEN.
While the NFL and all of its 32 teams have an effective established emergency action plan in place to prepare and be adequately equipped for the potential of a situation such as this from occurring, it's certainly a scenario no one ever wants to see.
"It seemed very much from the outside that they had all the available players - not the players themselves, but the medical players as far as physicians, EMTs, athletic trainers, paramedics available on site, ambulance - in which they could immediately go out there and attend to whatever the emergencies are," said the Director of the EMS Division for the UBMD Department of Emergency Medicine, Dr. Joseph Bart.
While CPR may not essentially bring a person back to life during a cardiac event, the act of administering CPR will allow for the individual to keep the flow of oxygen-rich blood going through the body to feed the essential organs like the heart, the brain, and all the other adjunct organs in order to keep them alive.
"When someone's in cardiac arrest, they have no heart rate and they are not breathing. By definition, they are clinically dead. That doesn't mean we gave up on them, it means they're clinically dead," Leising said. "There's only two things a dead person needs to bring them back: High quality chest compressions, and early access to defibrillation, or AEDs. Those are the only two things. ... You need to know how to do CPR, and you need to have early access to AEDs.
"If there's any lesson to be taken from [Monday] night is learn CPR. Four out of five cardiac arrests happen outside of a hospital. We as a community need to take this opportunity to learn it."
While medical professionals and other personnel are trained to be ready for situations such as Hamlin's to take place at any given moment, not just in a football game, the average citizen may not be fully aware of how to properly administer CPR in an emergency situation. Some may have taken prior training for CPR, but if several years have past since they were last certified, organizations like the American Heart Association and the International Cardiac Association may have altered or refined certain procedures to administer CPR.
Some medical professionals like Dr. Bart believe that not only is it important for more people to be better acclimated with CPR procedures, but it's just as important to identify those who will potentially be going to administer CPR in a community setting.
"There's an activation chain, we call 9-1-1, there's an expectation that an ambulance is on the way, and even under the perfect circumstances, all of that may very well be true, but there's a serious gap in that. And the gap that exists might be somewhere between 9, 11, 12 minutes, in which the ambulance and first responders are on the way. However, when they're on the way to get to you, what do we do in those circumstances? So initial access by first responders are generally lay rescuers," Dr. Bart said.
"I think the first thing to do is if you decided you might be the individual who would want to jump into action, there's really simple strategies, and some technique of CPR of getting on the chest and push hard and push fast. It's called the 'Hands Only CPR', and it's directed towards community members that don't have a lot of medical training but certainly understand the interface of doing CPR in those situations. There's no breathing component, there's no rescue airway things. It's just getting on the chest and trying to push hard and fast so that we can keep the blood circulating until professional rescuers arrive. That type of training is available for anybody, and the concept of that means that as soon as an injury or illness might happen that results in cardiac arrest, the person that may save you is the person that's standing next to you. In many cases, that may be an EMS professional or professional rescuer, but in most cases, it probably is not."
Organizations like the American Heart Association and the American Red Cross offer types of community courses through county and state level programs that not only get people up-to-speed with the latest CPR procedures, but can also get those who want to learn how to administer CPR certified.
Regional Director of Communications for the American Red Cross of WNY, Mike Tedesco says the thoughts of the organization are with Hamlin, his family, the Bills and the entire NFL community, and they're hoping he has a fast and full recovery.
"The takeaway is accidents and emergencies can happen anytime at home, in the workplace, in the community. And every second counts when someone experiences cardiac arrest. So it's critical people know what to do in an emergency," said Tedesco as part of a statement. "If you see someone suddenly collapse and you don't know CPR, call or have someone else call 9-1-1 and start hands only CPR. We recommend life-saving training for everyone. Parents, grandparents, caregivers. Our first aid training takes only a few hours, and can give you all the skills and confidence you need to act in an emergency, and potentially save a life."
To find out more information on where people can find opportunities to get proper CPR training, Tedesco encourages people to visit redcross.org/take-a-class/CPR.
Another life-saving concept that medical professionals feel some people should maybe have more training with is an automatic external defibrillator, or AED.
"The AED and the concept of that, and what it's able to recognize in almost an automatic fashion involves a few buttons," Dr. Bart said. "You put some pads on a patient's chest, you press a few buttons, and the machine does all the analysis and tells you what to do with that patient. If there's a potential shockable rhythm in those situations, it's absolutely game-changing."
Perhaps the best thing about AEDs is the fact that they do automate what has to be done to save a person's life and get a heartbeat restored.
"They literally have speakers and will tell you step-by-step what to do, and they will not shock somebody unless they need to be shocked. It won't let you," Leising said.
"When you're defibrillating somebody, you're not jumpstarting their heart. That's not how it works. You're actually turning it off temporarily, or you're turning off the electrical part of the heart and allowing it to reboot. When you defibrillate somebody, it's the same thing you do to your cell phone or your computer. When they act up, what do you do? You reboot them. Well, defibrillation, or the use of an AED, is exactly that. We're rebooting the heart, allowing it to get into a correct electrical activity that sustains life."
As for those who may have certification and happen to find themselves in a situation where they are needing to perform CPR or needing the use of an AED machine, Dr. Bart says it's important to activate the cascade of response that needs to happen within emergency medicine.
"As calmly and collectively as we possibly can there, the first thing we don't need people to do is to take out their phones and take a video. That doesn't really help anybody. But if you're going to take your phone out and dial 9-1-1, know where you are, give them a call back number so we can get the right resources there, because sometimes we may be in a bit of an obscure place. It's a park, it's on several floors in a building, it's a little bit off the beaten path. So having some accuracy of that, that's the first chain of survival is to activate the syste," Dr. Bart explained. "After that, if somebody chooses to be involved in this, then that's wonderful. There's nothing more altruistic than somebody saying from a community perspective, they want to be involved to help a stranger in a life-and-death situation."