Buffalo Bills’ safety, Damar Hamlin, is lucky to be alive. He suffered a cardiac arrest after he tackled a Cincinnati Bengals football player, Tee Higgins, on January 2, 2023 (https://apnews.com/article/Bills-damar-hamlin-collapse-what-happened-d73a76f2f7f736b652e95896dfaa0900). At the start of the play, Higgins caught a pass from Joe Burrow, the quarterback, from near the 50-yard line. Higgins ran downfield holding the football and leading with his right shoulder, he collided with Hamlin. As the two collided, Higgins’ right shoulder hit Hamlin in his chest. The protective chest gear that Hamlin was wearing, like all his teammates, was not strong enough to absorb the trauma and prevent the life-threatening injury that Hamlin endured. Following the incident, everyone thought that Hamlin would stand up, and walk away. Well, it started out that way, where Hamlin stood up following the encounter, but then collapsed and went into sudden cardiac arrest. Hamlin remained motionless while paramedics and team trainers attended to him within seconds. Buffalo Bills athletic trainer Denny Kellington was the first to initiate cardiopulmonary resuscitation (CPR) before first responders used an automatic external defibrillator (AED), and other measures for about 10 minutes while Hamlin was on the field. Kellington is now praised as a real-life hero (https://www.theguardian.com/sport/2023/jan/08/damar-hamlin-buffalo-bills-denny-kellington). Fortunately, an ambulance arrived at the scene about four minutes after Hamlin’s collapse, and he was shuttled to the hospital by an ambulance to receive further treatment.
At the hospital, Hamlin was diagnosed with a rare condition known as commotio cordis (Latin for “agitation of the heart”) which consists of an abnormal heart rhythm or ventricular fibrillation followed by cardiac arrest after being hit in the left side of the chest (https://www.nytimes.com/article/damar-hamlin-injury-update.html?smid=url-share; https://www.cbsnews.com/news/damar-hamlin-update-buffalo-bills-injury-nfl-condition-news/; https://parade.com/health/what-happened-to-damar-hamlin). The only way to survive commotio cordis is to receive CPR and defibrillation using an AED. An AED is a portable device that analyzes the heart’s rhythm and provides an electric shock to the heart to restore its normal rhythm. During commotio cordis, the heart’s rhythm can become distorted or stop altogether. An AED must be used to reset the heart’s normal rhythm. Failing to use such an instrument can result in the person collapsing, losing consciousness, becoming unresponsive, and dying. With each minute passing, a person’s chance of survival diminishes by 7-10 percent without the aid of CPR or defibrillation, and after 10 minutes, a person’s chance of survival is very slim (Sudden Cardiac Arrest Association, SCAA, https://associationdatabase.com/aws/SCAA/pt/sd/news_article/43774/_PARENT/layout_details/false). After cardiac arrest and defibrillation, many people have a long-term recovery, sometimes lasting for months or years (British Heart Association, https://www.bhf.org.uk/informationsupport/conditions/cardiac-arrest).
After this tragic on-field incident in a highly televised Monday Night Football game, this question arises: is it worthwhile for a player to engage in tackle football given the potential life-threatening injuries that may occur if the player is tackled (https://www.washingtonpost.com/kidspost/2023/01/12/damar-hamlin-injury-highlights-football-dangers/)? While Hamlin endured a chest injury and suffered a cardiac arrest, other injuries, such as a blow to the head through a protective helmet, may lead to a concussion. Concussions, if left undiagnosed, may lead to brain damage. Chronic traumatic blows to the head may result in irreversible brain damage called chronic traumatic encephalopathy (CTE).
To find out how The St. Paul’s Schools is prepared for injuries that may occur during football, or other sports, I interviewed Ms. Catherine Robinson (Head Athletic Trainer) (CR), Mr. Matt Hatton (Director of SP Athletics and Physical Education) (MH), and Mr. Matthew Byers (Middle School Administrator/English Teacher/SPS Radio Faculty Advisor) (MB).
Here are the questions and their responses.
Page & Epistle Staff (P&E): “Buffalo Bills safety Damar Hamlin suffered a cardiac arrest after making a tackle during a game against the Cincinnati Bengals on January 2, 2023. Have you seen a sports injury at St. Paul’s School like the one that happened to NFL player Damar Hamlin?
CR: “Thankfully, we have not experienced a sudden cardiac arrest (SCA) incident here on the campus of The St. Paul’s Schools during an athletic event. However, 2 years ago, there was a SCA during a lacrosse game on the campus of Loyola Blakefield. Due to the quick actions of the sports medicine staff and the prompt application and use of the AED (automated external defibrillator) on site, the student athlete survived and has subsequently returned to athletics.”
MH: “Fortunately, I have not seen a catastrophic injury at St. Paul’s like Damar Hamlin suffered in the Monday night game vs the Bengals in January. This is my first year at St. Paul’s and we have been fortunate that this type of injury has not presented itself this year to this point.”
MB: “I have not, but I’ve seen a number of times an ambulance had to be called, although usually out of an abundance of caution.”
P&E: “What was the worst injury and what is the most common injury during football games at St. Paul’s?”
CR: “In recent years, we have had multiple fractures and dislocations occur in our football practices and games. Fractures have occurred in almost all the long bones of the body. Dislocations of the shoulder, patella and phalange joints occur most often, but there have been more uncommon dislocations of the fibula and elbow, too. Another common injury is a torn anterior cruciate ligament (ACL).”
MH: “Football is a collision sport and unfortunately with this type of contact and competition often comes injury, some of which is significant. We endured a variety of injuries to our student athletes including an ACL tear, broken arm, ankles, shoulders, wrists, etc. Some of these injuries are more significant than others and a few of them required our student athletes to miss significant time and/or have surgery. I am not sure what the most common injury would be for sure. It would likely be some sort of soft tissue pull or strain, hamstring, quad, hip, etc.”
MB: “There was an incident in a MS Blue football game this past season that was a little scary as the player was down for quite some time and was just an 8th grader. It turned out to be not all that serious, but again, an ambulance was called, so you can’t be sure in the moment if you’re not witnessing a significant injury.”
P&E: What type of protective gear do players wear both in practice and during games to be guarded against serious injuries?
CR: “All football athletes are required to wear helmets, shoulder pads, a girdle, knee pads and a mouth guard. The equipment is required to meet the standards set forth by NOCSEA (National Operating Committee on Standards for Athletic Equipment) and certified by the Safety Equipment Institute (SEI) annually. Each piece of equipment is checked to make sure it is properly fitted as it is issued to the athletes.”
MH: “The equipment that our student athletes wear is dependent upon which sport(s) that they choose to pursue. The safety of our student athletes is of the utmost importance to our programs and our coaches, athletic trainers, and admin team work extremely hard to make sure that everyone has suitable equipment to protect from injuries. For instance, our football helmets and shoulder pads go through a yearly recertification process to be sure that they can adequately protect against head/neck trauma that has become prevalent in football. The pieces of equipment that either ages out (no longer suitable for protection) or does not pass certification gets removed from our circulation and must be filled back in with newer, certified equipment.”
P&E: Is the coaching staff at St. Paul’s trained in cardiopulmonary resuscitation (CPR) and automated external defibrillation (AED)?
CR: “Faculty/Staff coaches are trained in both CPR and how to use an AED. There is always an AED on the sideline of our contact sports athletic events. At St. Paul’s, we are fortunate to have over 20 AEDs on the campus in case a SCA event were to occur.”
MH: “Having all of our coaches and game day personnel (me included) trained and certified in CPR and AED usage is always our goal. Here at St. Paul’s, we are blessed that most of our coaches also teach here on campus. All our teachers have been trained in CPR and how to manage the AED in the case of an emergency. We are deliberate to work towards getting all our coaches who are not full-time teachers here at St. Paul’s up to speed on this type of training as well as making sure that we pair them with other coaches within their teams that have already been certified. Mrs. Cat Robinson, our head athletic trainer and her team, in conjunction with myself as director of athletics and the athletic training team at SPSG and their athletics administration, work hard in creating and communicating our Emergency Action Plan (EAP). Our EAP helps lay the groundwork for what and how things are done in the case of emergencies, which includes catastrophic athletics related injuries/situations.”
P&E: What does the medical support look like at a football game at St. Paul’s and when our team travels to other game locations?
CR: “During a football game at The St. Paul’s Schools there is always at least one athletic trainer on the sideline. During varsity football games, we also have a physician on the sideline. The sports medicine staff on The St. Paul’s Schools campus has put together emergency action plans (EAP) for all athletic venues. Our EAPs are reviewed and updated if needed on a yearly basis. When either the junior varsity or varsity football teams travel to an away contest one of our athletic trainers will travel with the team. Other schools may not have enough athletic trainers on staff to cover both sidelines which could put our athletes with an injury at risk for delayed care and complications.”
MH: “We are fortunate to have a great sports medicine team here at St. Paul’s. We always have one of our athletic trainers on site for home football, including middle school and JV games. Often, we have a student trainer present for home football games as well. We always have a team doctor on the sideline for all home varsity football games too.
We make it a priority to be sure that one of our athletic trainers also travels with our football teams on the road. This creates an extra layer of proactive care for our student athletes in conjunction with the hosts sports medicine team and doctors.”
Despite the tragic accident that hit Hamlin, he was lucky to be surrounded by competent professionals who immediately acted and saved his life. Recent news reports indicate that he has been cleared to return to football activities during the off-season training program of the Buffalo Bills and continue his career as a football player. At a news conference in April, Hamlin stated that “My heart is still in the game. I love the game” (https://www.nytimes.com/2023/04/18/sports/football/damar-hamlin-bills-return.html?smid=url-share). Just like Hamlin had professionals by his side when the accident happened during a football game, athletes at The St. Paul’s Schools can count on their athletic staff to help with any potential injuries while enjoying their sport.
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