Beck Water

With all respect - I think we should back away from the speculation and the opinions about the meaningful nature of 24 hrs on a ventilator. First of all, we don't know that Damar in fact had commotio cardis. Physicians are speculating that this is the cause of his cardiac arrest, but most also note that it is not a certainty. For example NYTimes article linked up thread: There are other causes, some discussed in this thread. It's also up to testing to rule out a heart attack, where cardiac arrest is caused by blockage. It's rare in a young guy, but it does happen, and commotio cardis is rare, too. Dr. Michael Mack, the chairman of cardiovascular services at Baylor Scott & White Health in Dallas pointed out: Note that this guy, a physician and the actual chairman of cardiovascular services at a major medical center in Dallas, cites 72-96 hours post-trauma as a period where "real concern" is warranted - not 24 hrs. He notes that comas may be induced to improve recovery. If Damar Hamlin was sedated and is being treated with the hypothermia protocols several linked up thread, drugs and not his injury are controlling how long he's under, and they may not even be trying to bring him out until tomorrow or Thurs. I don't put this out here to be a smart ass, but to counter manufactured deadlines of concern like "people SHOULD be concerned if he's still under after over 24 hrs". We aren't his medical professionals. We aren't treating him. Obviously it's optimal if he's conscious and waving as he gets loaded into the ambulance, but he wasn't. That being the case, his medical team is probably concerned about minimizing brain injury. It follows that when to be concerned depends on the treatment being administered and the expected course of treatment.

And to that point - in the more recent study I linked up-thread (the 69 person abstract references 1998 and 1997 papers), survival has improved DRAMATICALLY in more recent years, and the authors attribute this to increased AED availability. In the 10% study, there are indications that in many cases, you are correct. "34 occurring during organized competitive athletics and 35 that occurred during informal recreational sports at home, school or the playground or during other non-sporting activities." Organized competitive athletics do not uniformly have doctors or paramedics or even AEDs and people trained to use them, particularly when they involve younger kids, lower levels of competition, or poorer communities. Informal recreational sports at home or on the playground or during other non-sporting activities almost certainly don't.

There's an article in the Pittsburgh Gazette giving some more information about NFL emergency preparedness (details pertain to the Steelers but the framework is the same for any game. https://www.post-gazette.com/sports/steelers/2023/01/03/nfl-protocols-cardiac-arrest-steelers-acrisure-stadium-damar-hamlin-rayn-shazier/stories/202301030019

Just a point that on a normal week, player preparations for a Sunday game start the previous Wednesday.

As far as recognized cases of Commotio Cordis, never going to get a large number because it is rare. The problem I have is that the study referenced from 1998 appears to be superceded by a more recent study showing much improved survival rates of recent years. It's sort of like citing 1998 HIV survival rates in the face of much improved available treatments. Sure, you can have that, provided you put posts regurgitating random tweets from random reporters retweeting stats and studies that elicit the vomitus reaction there too.

Oh, Lori, No No Girlfriend, Don't do that, don't go there. First of all, as several have commented or linked tweets by doctors commenting, we don't yet know that it was Commotio Cordis. It's one possibility, but there are others. Second, These are two manuscripts from 1997 and 1998. A lot has changed since then in emergency medicine and in competitive sports. This is the more recent study we want https://www.heartrhythmjournal.com/article/S1547-5271(12)01254-4/fulltext Damar Hamlin had everything that leads to a better outcome going for him: Immediate CPR, immediate oxygen administration, immediate use of an AED (automated external defibrillator. His odds are likely to be even better than the 58% given for more recent 6 years. No, no. Don't toss around statistics from the land of "Someone Did My Own Research and came up with a Thing" God Bless Us Every One who try to educate ourselves, but the flaw is when you're not in that field, you don't necessarily see all the publications, you aren't able to put the results in context and critically evaluate the big picture.

This This This. And if you don't have the opportunity, please try to create the opportunity. The Red Cross and many hospitals have classes; some will come to your business or club and teach a class for a minimum number of people. Workplaces that have AEDs usually have an emergency squad, find out and ask to join.

I'm sorry.

I've never heard of that either, and I spent several years working in the ER of a major trauma center and have two nurse relatives who spent decades working at nursing homes and in hospice. If the patient/family want CPR, you do it and do your best. You don't make a judgement about "who won't survive" and decided to "fake it" and go through the motions. Good grief.

Thought it was moderated, and the moderators were part of the problem? Anyway we had a decent Chiefs fan drop by at one point and explained where the decent Chiefs boards were. Apparently even Chiefs fans regard Chiefs Planet as a Sinkhole.

Mix. Early photos he's surrounded by Bills staff, but emergency physician, airway specialist and paramedics would have quickly been summoned.

Is there a licensed retailer you recommend?

I'm not crying, You're crying. OK this one got me, I don't know why, I'm crying.

Hamlin had trainers running over to him right away and getting on their radios, likely to call for the emergency physicians and the code equipment So I think it's a very good assumption it was started right away. The only delay would have been to get his face mask unscrewed and enough of his pads removed to perform CPR. I would think that could be done PDQ.

People process things differently. Football players are definitely creatures of routine. Getting home so late - plane landed around 3 am, probably players not home before 3:30 or 4 am, this afternoon they will come in for evaluation and treatment of new or existing injuries, maybe a recovery workout. McDermott and/or team leaders may sound them out to see if they want to get together for a prayer service today and share verbally whatever details they have of the injury and explain the treatment, to counter rumors floating around the Twitterverse (but you have to do it verbally because some moth-head will tweet or re-tweet anything that's messaged and that's for the family to control.) I would expect that is something most of the players would want. I would expect the Bills would reach out and offer mental health services to the players. After that, people cope with things differently but many find it comforting to stick to a routine. These are all guys who are used to vigorous physical activity. Hard physical effort can take your mind off things, and relieve stress and anxiety. If something tragic happens, a routine can always be stopped, but if there's a decision to play, neglected preparations can never be retroactively started.

Thank you! Really good article.

It's really going to depend upon the outcome for Damar, I think. If he comes out of sedation on Weds and is alert and able to communicate "Go Bills!" that's a very different situation than if he remains in a coma.

At the least, note the manufacturer and model and contact them regarding the recommended maintenance schedule. They do vary depending upon the age of the unit, the type of battery etc. Then follow it Yes, the battery should be checked, but periodically, according to the mfr recommendation, it should actually be inspected and calibrated to be sure that the programming is functional and the shock delivered is up to spec. This was 1x/yr where I used to work.

The AEDs at my former place of employment were checked every year. That should be the case for AEDs in shopping malls, stadia, etc but Who Knows? Emergency medical equipment positioned for the use of medical professionals (paramedics or hospital) should be checked once a shift. I can't imagine the medical professionals on-call for an NFL game not checking the equipment before each game.

I can try very briefly. We have far more knowledgeable people here who are likely busy treating patients but I have full confidence will nonetheless put me right if I'm wrong. -For certain emergency conditions, including neurological trauma AND cardiac arrest (heart stoppage), one protocol calls for chilling the patient's body for 24 hrs -The patient is then re-warmed over 12-20 hrs -To accomplish this, the patient is sedated and put on a ventilator, which breathes for them. -While they're sedated and ventilated, we get none, zero, no info about their ability to breathe on their own, their neurological function and so forth, because, we're not talking give them a little Valium - this is serious, OR-grade sedation So if this is the protocol being followed, doing the math, 24 + 12 or 20, we would expect no "good news" updates about Hamlin for at LEAST 36-44 hrs, until Weds morning or afternoon. If you are stressed out and unable to eat or sleep, Please, for your health, take a walk, go look at your favorite view, pat some grass, eat a ***** snack, and take a nap. By the way, the protocols I've found on this procedure (new since my decades-old time in the ER) all state that no alteration of care or decision based on the patient's neurological status should be made for 72 hrs after the cooling and re-warming protocols are completed - which is why that Twitter dudes "update" is to be disregarded and treated with the respect it deserves 💩

Covers the NFL for PFF. NY based.

Ha! Well, you got me there....

I would like this 1000x if I could. Well someone likely knows, but they're busy treating Hamlin and their other patients.

I'm sorry you took it that way. I'm not trying to out-smart you, or anyone. My point is that medically, there are a number of key differences between Hamlin's situation, and your brother's situation. There are reports out there in Twitter, some of which have been copied here, about brain scans on Hamlin. We don't know that Damar suffered a spinal cord injury or a brain injury. We know nothing about the cause of Hamlin's cardiac arrest at this point, and medically, that matters a lot. We know that he suffered a cardiac arrest, and that apparently current SOP is to chill the patient, sedate and ventilate them, and wait. And again, I'm sorry for your loss.

I am sorry for your loss, and clearly you went into a situation that is similar, where once the patient is in medical care, the family has no choice but to wait and pray for the best outcome while the hours tick by. Medically, and I think this is important to note, this is NOT the same situation as your brother experienced, in a number of critical aspects. I mean no disrespect, but this is a fraught time with everyone combing the interwebs for scraps of information, so I think it's important to point this out. My respect for Pat McAfee and his Pro Wrestler Persona just went up a notch