Damar Hamlin is headed home to Buffalo!

AlNipper49

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Just watching the news this morning and they had a leading cardiologist on who echoed this opinion. But he went further and said heart restart isn't the end game. He said a critical concern is potential neurological injury if the brain does not receive sufficient blood flow / oxygen. An additional step to help avert this is to induce a coma and concurrently lower the body's core temperature (I didn't hear him if he mentioned what that temperature is). Then he said there is a significant degree of discretion on when to return the body to normal temp and bring the patient out of the coma.
I've heard "induce hypothermia" a few times in reading about it (including here :) ) . To be clear, this was in context to what could occur and/or may have occurred in similar cases. It's not clear that this happened here, but hypothermia occurs when your body temp falls below 95 degrees.
 

nolasoxfan

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With this incident it puts into focus how insane it is that auto races have always continued after driver deaths.
‘The show must go on’ is a deeply held tenet within the entertainment business, professional sports industry included. I was happy to see that principle challenged last night.
 

BigSoxFan

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‘The show must go on’ is a deeply held tenet within the entertainment business, professional sports industry included. I was happy to see that principle challenged last night.
No better example than Owen Hart.
 

DontTauntOrtizMe

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Can anyone help me understand something...did they use an AED on the field and is that the same as what CPR does?
I’m not a doctor but my understanding is the AED device is the shock to restart a heart and CPR is the chest compressions used to pump blood while the heart is stopped.
 

AlNipper49

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Can anyone help me understand something...did they use an AED on the field and is that the same as what CPR does?
They are distinct tools/processes. The TLDR is that CPR is administered immediately to keep the body oxygenated, most importantly the brain. It also pushes blood into the heart, which creates a more favorable condition for AED. CPR almost never "brings someone back from dead". The AED shoots electricity into the body and can actually restart a heart. If you are somewhere where you suspect someone has had a heart attack then immediately alert 911 and begin to administer CPR to keep the blood flowing. Instruct another person nearby to locate an AED. Many modern AEDs (like ours) will actually be fairly idiot-proof and shoot directions at you, however, if this happens to you then by this time you should be on with 911 and get direction from them. However, 911 always isn't available, so it's important to get an AED that matches the skill sets of the people who would theoretically administer it.
 

AlNipper49

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Thank you, and do we know if the AED was actually used?
Yes, they did use an AED in addition to CPR.

Every single person reading this thread should have CPR training. There is literally no reason to not get it. Even if you are not certified you can get it online, which is better than nothing.
 

flymrfreakjar

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Bills official account said that he suffered cardiac arrest and his heartbeat was restored so my guess is that an AED was used.
 

RedOctober3829

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Yes, they did use an AED in addition to CPR.

Every single person reading this thread should have CPR training. There is literally no reason to not get it. Even if you are not certified you can get it online, which is better than nothing.
I get CPR training every year with my job as I work closely with athletes. It's so important. You never know what could happen and unfortunately we found out last night.
 

BaseballJones

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I get CPR training every year with my job as I work closely with athletes. It's so important. You never know what could happen and unfortunately we found out last night.
I do too and you're 100% right. I hope to God I never have to use it in real life.

I was thinking about this though - I coach HS volleyball so doing a chest compression would not be that difficult given the nature of a volleyball uniform. But football shoulder pads cover a fair amount of the chest. Given how tight their uniforms are over those pads, I wouldn't think that doing chest compressions on a football player wearing pads would be easy. Where you're supposed to do the compressions is covered by the pads, which are designed to take a substantial hit. Kudos to the medical people who were able to work on him.

59630
 

Steve Dillard

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My brother in law's brother in law had an afib episode a month or so ago, with a delayed response by first responders of about 15 minutes. At the hospital they lowered his body temp but the doctors cautioned his wife to the potential of a persistently vegitative state due to the time lapse. Semi miraculously given that warning, he emerged from the induced coma with some minor short term memory issues, and a bit of a personality change (its only the first couple of months, so who knows what returns), but the motor function and longer term processing seems to be at a pretty high level. My brother in law (doctor) who visited him said the cooling was critical to minimizing brain injury.
 

chechusma

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An AED (Automated External Defibrillator) is very close to foolproof for lay people. It’s basically two large-ish stickers you place in the chest (both to read the heart rhythm and to apply a shock) that are connected to the box which has both the computer that interprets the heart rhythm and the generator that delivers the shock. You put the stickers on (there is a diagram on the AED), turn the machine on, and then the machine audibly states “shock advised” or “no shock advised.” If it says shock advised, a little button lights up for the resuscitator to push and deliver a predetermined shock. Very simple and amazing/lifesaving device.

what we use in the ED (and in ambulances) is similar set up with the stickers/wires etc, but there is also a little screen where we can see the EKG tracing and decide on our own whether a shock is advised, or not; as well as options for changing the energy of the shock delivered. (Some other bells and whistles but that is the main difference).

I’m guessing they used an AED, which is perfectly fine in 95% of these situations, where minimizing “time to defibrillation” is of paramount importance (again, see survival rates in casinos versus other locations)
 

YTF

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They are distinct tools/processes. The TLDR is that CPR is administered immediately to keep the body oxygenated, most importantly the brain. It also pushes blood into the heart, which creates a more favorable condition for AED. CPR almost never "brings someone back from dead". The AED shoots electricity into the body and can actually restart a heart. If you are somewhere where you suspect someone has had a heart attack then immediately alert 911 and begin to administer CPR to keep the blood flowing. Instruct another person nearby to locate an AED. Many modern AEDs (like ours) will actually be fairly idiot-proof and shoot directions at you, however, if this happens to you then by this time you should be on with 911 and get direction from them. However, 911 always isn't available, so it's important to get an AED that matches the skill sets of the people who would theoretically administer it.
As a side note, many years ago when my then workplace invested in a portable AED we were also instructed to remove any metal necklaces and the kit was actually equipped with scissors that would cut through bras with under wiring so not to burn the person that aid was being administered to. I believe that particular unit was also hard wired so that as soon as it was removed from it's station a call was sent to 911.
 

RedOctober3829

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I do too and you're 100% right. I hope to God I never have to use it in real life.

I was thinking about this though - I coach HS volleyball so doing a chest compression would not be that difficult given the nature of a volleyball uniform. But football shoulder pads cover a fair amount of the chest. Given how tight their uniforms are over those pads, I wouldn't think that doing chest compressions on a football player wearing pads would be easy. Where you're supposed to do the compressions is covered by the pads, which are designed to take a substantial hit. Kudos to the medical people who were able to work on him.

View attachment 59630
The ATC's are trained to cut right down the middle of the pads and unscrew the face mask to administer CPR and AED. Everyone that has kids involved in youth sports needs to be aware of where or if there is an AED on the premises and also be familiar with any athletic training staff that works with your children. They are the unsung heroes.
 

BaseballJones

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The ATC's are trained to cut right down the middle of the pads and unscrew the face mask to administer CPR and AED. Everyone that has kids involved in youth sports needs to be aware of where or if there is an AED on the premises and also be familiar with any athletic training staff that works with your children. They are the unsung heroes.
Yep agreed. And that makes sense regarding the pads. Like I said, my sport, it's much easier. Not that I ever want to have to deal with this.
 

fiskful of dollars

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I do too and you're 100% right. I hope to God I never have to use it in real life.

I was thinking about this though - I coach HS volleyball so doing a chest compression would not be that difficult given the nature of a volleyball uniform. But football shoulder pads cover a fair amount of the chest. Given how tight their uniforms are over those pads, I wouldn't think that doing chest compressions on a football player wearing pads would be easy. Where you're supposed to do the compressions is covered by the pads, which are designed to take a substantial hit. Kudos to the medical people who were able to work on him.

View attachment 59630
You are right - you can't do effective compressions with pads in place. However, these pads are easily removable in trauma in order to access the chest AND maintain spine, C-spine precautions (i.e. patient is flat, in a c-collar and on a spine board). They come apart in a few seconds.
Interestingly, you can clearly see how the anterior chest is protected which makes commotio cordis seem less likely since the impact would be spread out over a larger surface area. Still, a distinct possibility but unusual given his age, the nature of the blow and the protective equipment.
 

MonstahsInLeft

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My brother in law's brother in law had an afib episode a month or so ago, with a delayed response by first responders of about 15 minutes. At the hospital they lowered his body temp but the doctors cautioned his wife to the potential of a persistently vegitative state due to the time lapse. Semi miraculously given that warning, he emerged from the induced coma with some minor short term memory issues, and a bit of a personality change (its only the first couple of months, so who knows what returns), but the motor function and longer term processing seems to be at a pretty high level. My brother in law (doctor) who visited him said the cooling was critical to minimizing brain injury.
Yes. I'm not intimately familiar with it for adults (Pediatrician) but it's a standard protocol for newborns after a delivery goes poorly and there was inadequate perfusion to the brain.

The bottom line is that there's initial cell damage from the time the brain isn't getting adequate oxygen but AFTER blood flow is restored there's a whole cascade of inflammation and damage that occurs and can cause even worse complications than the initial insult (often called "re-perfusion" damage).

The induced coma and cooling tries to minimize that secondary damage and improve the outcome.

edit: to some degree it's similar to "second concussion" effects in that you can have this exaggerated inflammatory response if the brain isn't back to "normal" yet and that can cause more serious injury than the repeat concussion itself.
 
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BaseballJones

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You are right - you can't do effective compressions with pads in place. However, these pads are easily removable in trauma in order to access the chest AND maintain spine, C-spine precautions (i.e. patient is flat, in a c-collar and on a spine board). They come apart in a few seconds.
Interestingly, you can clearly see how the anterior chest is protected which makes commotio cordis seem less likely since the impact would be spread out over a larger surface area. Still, a distinct possibility but unusual given his age, the nature of the blow and the protective equipment.
Yeah it's really crazy that this happened given that he was wearing these pads. It's one thing for a little leaguer to take a line drive off his chest with no padding whatsoever. But these guys wear this protection. Has to be like a one in a billion kind of event for football.
 

Jimbodandy

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Yes, they did use an AED in addition to CPR.

Every single person reading this thread should have CPR training. There is literally no reason to not get it. Even if you are not certified you can get it online, which is better than nothing.
I'd like to add to the chorus on this. Took the opportunity when it was offered in work in 2013 and 2015. Last time that I had it was the early 1980s as a boy scout. It has changed a little but not that much.

Not only do you learn CPR, but the class that I took had a walkthrough on using an AED also. And there were tips and techniques for managing the situation if someone drops like getting them onto a flat, hard surface (can't do CPR effectively on a couch), having someone meet EMTs at the entrance to shorten the lag and get the patient professional care just a bit faster. It's worth the couple of hours investment to take the class. Might save a life.
 

Cotillion

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Seems weird so many players stayed dressed in pads for so long for a game that the NFL never considered re-starting.
 

rsmith7

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You are right - you can't do effective compressions with pads in place. However, these pads are easily removable in trauma in order to access the chest AND maintain spine, C-spine precautions (i.e. patient is flat, in a c-collar and on a spine board). They come apart in a few seconds.
Interestingly, you can clearly see how the anterior chest is protected which makes commotio cordis seem less likely since the impact would be spread out over a larger surface area. Still, a distinct possibility but unusual given his age, the nature of the blow and the protective equipment.
Having seen them in action, the first responders can cut and unscrew in the blink of an eye.
The image of the pads above represent maximum, and perhaps outdated, coverage. Pads these days differ by position, with some having much less "hard shell" coverage to allow greater range of movement.
See: www.douglaspads.com/collections/custom-pro/products/69
 

Humphrey

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I'm all for criticizing the NFL but I'll give them a bit of a break here. I think the 5 minute thing is SOP. It was SVP who said that the NFL was considering restarting the game. It should be noted that Van Pelt was reporting from. Washington and not the stadium. Someone might have read the NFL handbook and just started that rumor based on what the standard operating procedure is to restart play following an injury without consulting the NFL.
The other factor to consider is that the NFL has not had to deal with a life or death situation of a player in 50 years since the Chuck Hughes tragedy in 1970
In Hughes' case, it happened w/a minute to go in a close game and, believe it or not, they actually finished the game. Probably only another play or two, but I remember thinking at the time it was pretty crass to finish the ballgame.

"
On October 24, 1971, the Lions hosted the Chicago Bears at Tiger Stadium. Late in the 4th quarter, with Detroit trailing 28–23, the Lions were driving into Chicago territory and Hughes, who entered the game as an injury replacement, caught a pass from quarterback Greg Landry for 32 yards and a first down at the Bears' 37-yard line.

Three plays later, Landry threw a pass that tight end Charlie Sanders dropped near the end zone. Hughes, a decoy on the play, began running back to the huddle with 1:02 showing on the clock. Suddenly, he dropped to the turf clutching his chest around the 20-yard line.[3] Hughes collapsed near Bears linebacker Dick Butkus, who saw him begin to convulse violently on the field. Butkus motioned to the sideline frantically to get Hughes assistance.[6]

Both teams' doctors and trainers, along with a physician who happened to be attending the game, ran to Hughes to try to save him. An ambulance was called for and arrived to take Hughes to Henry Ford Hospital, where he was pronounced dead at 5:34 pm that afternoon. He was 28 years old. The game was played to its conclusion in front of a now-stunned silent crowd in Tiger Stadium, with the Bears' lead holding. The Lions awaited word of Hughes' condition after the game and the players were informed once word had broken that he was dead. "
 

nolasoxfan

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Yes, they did use an AED in addition to CPR.

Every single person reading this thread should have CPR training. There is literally no reason to not get it. Even if you are not certified you can get it online, which is better than nothing.
Thanks for this reminder. I was trained in the 80s as a young lad, but long past time for a refresher course. I needed a New Years resolution, anyway, and this seems like a good one.
 

AlNipper49

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Seems weird so many players stayed dressed in pads for so long for a game that the NFL never considered re-starting.
I think that if I was watching a dude kinda sorta dying in front of me that changing clothes would not be a huge priority at that moment.
 

ngruz25

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Yeah it's really crazy that this happened given that he was wearing these pads. It's one thing for a little leaguer to take a line drive off his chest with no padding whatsoever. But these guys wear this protection. Has to be like a one in a billion kind of event for football.
It might be worth noting that pads have been shrinking on wide receivers and defensive backs for years. Smaller pads mean more speed and mobility. The NFL had to crack down on thigh pads a few years ago as a number of receivers had started removing them from their pants.
 

radsoxfan

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The one nugget of good info released was that they were able to re-start his heart on the field (and presumably got a pulse).

Things obviously go south very quickly if blood isn't getting to the brain, but hopefully the combination of immediate CPR and a "relatively short" cardiac arrest will work in his favor.

His docs likely won't know the full extent of any damage until he is out of the coma.
 

BaseballJones

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It might be worth noting that pads have been shrinking on wide receivers and defensive backs for years. Smaller pads mean more speed and mobility. The NFL had to crack down on thigh pads a few years ago as a number of receivers had started removing them from their pants.
I wonder if this event will make the NFL require bigger pads, even at the sacrifice of speed and mobility.
 

NDame616

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Zo (yes I know) said that one of the Buffalo radio guys was saying the teams were told to be ready to play tomorrow. Grain of salt and such
 

AlNipper49

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Thanks for this reminder. I was trained in the 80s as a young lad, but long past time for a refresher course. I needed a New Years resolution anyway.
Definitely not a replacement for in-person but this is the training that we require any adult volunteer to complete. Sudden Cardiac Arrest Course (nfhslearn.com)

In-person is MUCH different. I've taken in person probably 6 times (I chaperone summer camp every year and frankly there isn't much else to do). Every single time that I take it I do not press hard enough on the chest compressions. 2" doesn't seem like much until you have to actually press that deep in person. (alas this thread is too serious for the requisite that's what she said)
 

8slim

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1) I'm 49, have been avidly following the NFL since I was 8, and I've never heard of Chuck Hughes. Maybe that's on me, but I can't recall a single time where I've heard his story told.

2) Many years ago my mom, a nurse, had to quickly administer CPR to someone who had a cardiac event in a restaurant. Sadly he eventually passed, but her quick action kept him alive until the paramedic arrived. This was before AEDs were somewhat ubiquitous. I wonder if the guy she assisted would have lived had those been available.
 

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It might be worth noting that pads have been shrinking on wide receivers and defensive backs for years. Smaller pads mean more speed and mobility. The NFL had to crack down on thigh pads a few years ago as a number of receivers had started removing them from their pants.
FWIW, all pads have been shrinking for years. Check out clips of what linemen looked like 30 years ago—their pads were huge. Not only has technology improved, but linemen want less surface area so there is less to grab onto.
 

fiskful of dollars

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Definitely not a replacement for in-person but this is the training that we require any adult volunteer to complete. Sudden Cardiac Arrest Course (nfhslearn.com)

In-person is MUCH different. I've taken in person probably 6 times (I chaperone summer camp every year and frankly there isn't much else to do). Every single time that I take it I do not press hard enough on the chest compressions. 2" doesn't seem like much until you have to actually press that deep in person. (alas this thread is too serious for the requisite that's what she said)
Yes! Hard and fast is the rule. 1 1/2 to 2 minutes or so and you should need to swap out. That’s how strenuous the effort should be. My constant refrain during a resuscitation is “those compressions need to be harder and faster”.
 

PC Drunken Friar

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Zo (yes I know) said that one of the Buffalo radio guys was saying the teams were told to be ready to play tomorrow. Grain of salt and such
If this is true, do they move the Patriots to Monday? I think we have seen Monday's game moved to Tuesday before, and then they play again on Sunday. And of course the Sunday to Thursday turnaround is common. 4 days rest seems to be the minimum (is it in the CBA?). Wednesday to Sunday, after an event like this seems crazy.
 

NDame616

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They can't play on Monday. It's the NCAA championship. Can't compete with it
 

NDame616

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They could play Monday afternoon.
I'm not going to pretend to know the ins and outs of the contracts, but they may have an all out non compete on that day. NCAA and it's billions in ads and sponsors wants to be the only game in town on Monday.
 

mr_smith02

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1) I'm 49, have been avidly following the NFL since I was 8, and I've never heard of Chuck Hughes. Maybe that's on me, but I can't recall a single time where I've heard his story told.
I am 52 and I have never heard this story until now.
 

Marbleheader

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As a teacher, I recertify every two years for CPR. It's usually less than two hours depending on the size of the group. They way they explain it, you want to flatten the heart with compressions, so it is strenuous. The dummies they use have a light that comes on once you have the right amount of pressure. Compress to the beat of 'Stayin' Alive', The Office episode is actually correct about that.
 

rmurph3

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I'm not going to pretend to know the ins and outs of the contracts, but they may have an all out non compete on that day. NCAA and it's billions in ads and sponsors wants to be the only game in town on Monday.
Which is fine, at that point the NFL's concern is just getting back on schedule. Play with no broadcast if that's what it takes.
 

dcdrew10

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Yes, they did use an AED in addition to CPR.

Every single person reading this thread should have CPR training. There is literally no reason to not get it. Even if you are not certified you can get it online, which is better than nothing.
This a 1000 times. I had to use CPR on a neighbor who collapsed at the park one day. He didn't make it, but the number of people who couldn't/didn't know what to do was staggering. It's heartbreaking to be with a guy trying to save him while his family watches.
 

BaseballJones

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Not a CPR story but when my oldest son was just about four years old, he was in the kitchen and we parents were in the living room. He walked into the living room pointing to his throat, clearly having put something in his mouth and was choking, couldn't breathe. I calmly (so I thought) picked him up over my lap and put my hand under his chest and banged on his back and dislodged the food. I hadn't received any training and don't even know if I handled it correctly. It worked, thankfully. But it was a very scary moment. I was actually impressed with how calm and composed I was in the moment, to be honest, but again, not sure if I did it correctly.

I wish I had had some training, so I'm in full agreement with everyone here saying that it would be great if everyone got this kind of training.
 

MonstahsInLeft

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As a layman in all things medical, I'm wondering how in the world the research went that led to determining induced coma and cooling helped in a situation like this.
Off the top of my head (in clinic so can't chase it down now) I believe it might have been initially based on recoveries of drowning victims, especially cold water, who occasionally have been resuscitated after REALLY long delays and had much less brain damage than would be expected.

There at least used to be a saying with resuscitations that no one was pronounced as "dead" until they were "WARM and dead" because of that affect.
 

BaseballJones

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I wonder when these guys get back on the field (whenever that is), how triggering it will be if another player falls to the turf injured, maybe from concussion-like symptoms or from another serious injury (like a knee or whatever). Just seeing another teammate go down might be massively traumatizing for these guys.