PHILADELPHIA (KYW Newsradio) — The football world was shocked by the sudden collapse of Buffalo Bills safety Damar Hamlin during the first quarter of Monday Night Football against the Bengals.
The Bills said the 24-year-old’s heart stopped immediately after a tackle, and he received CPR and other medical attention on the field for nearly 20 minutes before he was transported to a hospital.
“Damar Hamlin suffered a cardiac arrest following a hit in our game versus the Bengals. His heartbeat was restored on the field and he was transferred to the UC Medical Center for further testing and treatment,” the Bills said in a statement. “He is currently sedated and listed in critical condition.”
Hamlin, from McKees Rocks, Allegheny County, played for Pittsburgh Central Catholic High School and the University of Pittsburgh before joining the NFL.
The Cincinnati game has been indefinitely postponed as Hamlin remains in the hospital. Looking at his unique case — with the caveats that the public is not privy to his medical records or hospital status at this moment — KYW Newsradio’s medical editor Dr. Brian McDonough breaks down what appears to have happened to Hamlin on the field and what that means for professional and student-athletes.
What is the biggest concern for Hamlin right now?
Footage of the incident shows Hamlin taking a hit to the chest, standing up and walking a couple of steps, then falling to the ground on his back, all within a few seconds.
“The biggest concern right now is, did he have a period of time where he was not getting enough oxygen to his brain?” McDonough asked. “If you catch a hit to your chest at the right time in the heartbeat — which is essentially the wrong time in the heartbeat — it can actually cause an issue called commotio cordis, where you’re sent into an unusual rhythm.
“It can actually go into [ventricular fibrillation] — it can actually stop or be really an issue.”
The emergency team worked fast and performed the necessary steps, including CPR. Reports said they also used an AED (automated external defibrillator) to jumpstart his heart. But, it’s still not known how long Hamlin’s brain went without oxygen.
“Because they were working on him for an extensive period of time, what was that period of time where he wasn’t getting oxygen to the brain?” McDonough asked. “That’s the concern, because they got the heart rate back, they sent him to the hospital. And again, reports are that he does have a tube, which essentially means they’re helping oxygenate him.
“He’s young, he’s in good shape. He has all those other health things [going] for him. … It’s just the entire period of time there — what happened and why? It’s less important right now what happened but how they’re managing him right now.”
What is the likelihood of commotio cordis?
Dr. Sanford Gips, a Jefferson Health cardiologist at Heart House in South Jersey, agrees with McDonough that Hamlin likely suffered commotio cordis.
He said the hit to the chest has to occur within a few hundredths of a second at a specific moment, thus disrupting the heartbeat cycle. It’s more common after being struck by a baseball or a hockey puck.
Former Philadelphia Flyers player Chris Pronger survived the same injury in 1998 after being hit with a slap shot.
“Ninety percent of people who have this condition don’t survive it,” said Gips.
However, Gips said it’s actually good that Hamlin is sedated while in critical condition. Doctors likely lowered his body temperature and sedated him to take stress off the heart.
He could possibly make a full recovery, and even play football again, but the next day or two will be crucial.
What does critical care entail?
The exact care Hamlin is receiving is not publicly known, but the NFL has said that he is sedated and in critical condition. McDonough said Hamlin would be in a setting like a cardiac intensive care unit.
“They’re going to see how he responds,” McDonough explained. “In other words, studies can be done to look at his brain function. Studies can be done to manage his heart, those types of things. If it was the jolt that caused the irregular heartbeat, and there was nothing underlying, that’s a one-time episode that should not occur again for him. It was just bad timing.
“If there was something that was anatomic that wasn’t picked up on prior exams, then, of course, they’d be dealing with that as well. So it all comes down to the cause and then how he responded.”
McDonough emphasized that a cardiac arrest like the one Hamlin suffered is quite rare; it really has to be the “right time in the heartbeat, in the way the heart beats that he got hit.”
“It just was a hit at that time in the right place — if that in fact was the cause. And most of the people who are watching — experts, cardiologists, others — are suspecting … that was probably the reason.”
Has a similar situation to Hamiln’s happened before in an NFL game?
Only once in the NFL’s history has a player died on the field.
On Oct. 24, 1971, 28-year-old Detroit Lions wide receiver Chuck Hughes – a Philadelphia native who played three seasons with the Eagles from 1967-1969 – collapsed late in the fourth quarter of a game between the Lions and Chicago Bears.
Hughes died within minutes of a heart attack brought on by a blood clot.
An AFL player, 24-year-old New York Titans guard Howard Glenn, suffered what an autopsy later revealed was a broken neck during a game against the Houston Oilers on Oct. 9, 1960.
He collapsed after the game in the locker room and died at a hospital.
Hamlin was saved by quick action from the Bills and Bengals medical staff, and timing is key to surviving a cardiac episode.
“For every minute you lose, it’s a 10 percent greater risk for organ damage and heart damage, getting blood to the brain, everything,” McDonough said. “The critical thing is to get blood flow to the body and the brain.”
Related
Could Hamlin’s medical incident change sports protocols?
These types of incidents are difficult to prevent, McDonough said, but medical events do happen, and episodes like Hamlin’s can happen at the pro or amateur level.
The key, he said, is making sure there is always an AED on site — and that extends to high school and college sports.
“For the average player, the average athlete, to know about this is important,” he added. “The big message here is if you have organized sports, you gotta have that AED on site. It can make a difference. And, they’re made now that the average person can use it.
“I also think learning CPR is a really important thing for all of us because you just don’t know when things will happen, and you want to be as prepared as you possibly can for those situations.”