I WAS SHOCKED AS I WATCHED THE ON-FIELD COLLAPSE AND CARDIAC ARREST of National Football League (NFL) safety Damar Hamlin after a tackle on “Monday Night Football.” The football player Hamlin’s on-field collapse reminds me to know CPR.

On Monday night, I watched as Damar Hamlin had cardiopulmonary resuscitation (CPR) on the football field. Medical personnel quickly shocked his heart back into a normal rhythm. Meanwhile, distraught players openly cried, and the National Football League (NFL) suspended the game.

In an early morning statement the following day, the Buffalo Bills organization reported that Hamlin’s “heartbeat was restored on the field” and that the football player was under sedation at the University of Cincinnati Medical Center.

Just over three days later, Hamlin awakens and shows his brain function is intact:

Doctors: Hamlin shows’ substantial improvement buffalo Bills safety Damar Hamlin is beginning to awaken.

Bills safety Damar Hamlin is beginning to awaken.

www.espn.com.

While the American football player is recovering, Dr. Timothy Pritts reminds us that Hamlin is critically ill. Thankfully, his neurological function appears to be intact. The 24-year-old is moving his hands and feet and communicates by writing (while unable to speak — he is still on a mechanical ventilator).

Hamlin’s first written communication upon awakening from his deep sedation-induced multiday sleep? He offered a note with this question: “Did we win?”

I love Dr. Pritts’ response: “The answer is yes, Damar, you won. You won the game of life.”

Cardiac arrest remains a public health crisis.

Sudden cardiac arrest is not uncommon and remains a public health crisis. The American Heart Association Heart and Stroke Statistics — 2022 Update shows the following:

There are more than 356,000 out-of-hospital cardiac arrests (OHCA) annually in the U.S., nearly 90 percent of them fatal. That translates to nearly 1,000 individuals daily.

The survival to hospital discharge after emergency medical services (EMS)-treated cardiac arrest languishes at an unimpressive 10 percent.

Sports-related sudden cardiac arrest

Sports-related sudden cardiac arrest (SCA) represents the following percentages of SCA by age in Portland, Oregon (USA):

Two other important observations:

• The sudden cardiac death incidence during youth sport participation is approximately 1.83 deaths per 10 million athlete years.
• Pre-participation screening of 5,169 middle and high school students (with an average age of 13) from 2010 showed high-risk cardiovascular conditions in approximately 1.5 percent.
• Recent research indicates the incidence of out-of-hospital cardiac arrest in children in the USA is 23,514.

Covid-19 pandemic and cardiac events

You may wonder how the COVID-19 pandemic has affected the incidence of out-of-hospital cardiac events. In New York City, the incidence of OHCA attended by emergency medical services tripled in 2020 compared with a year earlier.

In addition, the pandemic brought increased delays in starting CPR for out-of-hospital cardiac arrests. Despite no chance in the frequency of bystander CPR, there was a drop in the frequency of shockable rhythms, bystander AED (Automated External Defibrillator for shocking the heart back to a normal rhythm) use, and out-of-hospital cardiac arrest in public locations.

Timely, quality CPR is key to survival

Within seconds of the nationally televised event, medical personnel from Cincinnati’s Paycor Stadium initiated high-quality cardiopulmonary resuscitation (CPR) on Damar Hamlin. Soon, an ambulance came onto the field to rush Damar Hamlin.

The quick medical response likely saved Hamlin’s life. A doctor appeared by Hamlin’s side within one minute of his collapsing and immediately determined that the player had no pulse. CPR immediately began.

Cardiac arrest, CPR, awareness, and treatment

About one in six (18 percent) individuals in the United States report recent CPR training. Nearly two in three reports having had CPR training at some point.

CPR training rates appear lower in older people, those with less formal education, lower income groups, and Hispanic/Latino individuals. That’s according to a survey of over 9,000 people in the USA in 2015.

Here are the leaders in laypeople-initiated CPR for out-of-hospital cardiac arrests (OHCA):

Non-medical professionals used the “shocking device” (AED) in six percent of events, delivering a shock in 1.3 percent.

Laypeople used AEDs in nine percent of out-of-hospital cardiac arrests. States with higher use rates include Nebraska (16 percent), Alaska (10 percent), Minnesota (9 percent), Oregon (13.5 percent), Washington (11 percent), Pennsylvania (10 percent), North Carolina (9.5 percent), and Utah (9.5 percent).

Cardiac arrest — My take

First, learn CPR. It is important for all of us, especially those with sport-playing children. A kid can get hit in the chest by a baseball or basketball. A cardiac arrest can occur if the strike is in the wrong chest location at precisely the wrong time in the heart’s electrical cycle.

Second, please advocate for AEDs everywhere that is reasonable. All malls, schools, and other well-traveled public spaces should have them.

Third, never be afraid to use the AED. The machine tells you exactly what to do and will not ask you to deliver a shock unless needed.

I took a CPR refresher course last week. You should consider taking one, too.