Hamlin Incident Demonstrates Importance of Molloy Programs and Training

On Monday night January 2, 2023, over 26 million people collectively held their breath as they watched Damar Hamlin suffer cardiac arrest and immediately receive on-field treatment during a Monday Night Football game. Hamlin, who plays for the Buffalo Bills, is 24 years old and by all accounts in remarkable physical condition. So why then was he, the NFL and by extension the viewers thrust into such a palpable and surreal experience?

“I was watching the game,” said James Zegers, Molloy University, Associate Athletic Director for Sports Medicine. “My first thought was it was likely a head injury because they’re so common now, especially in football. But after watching the replay and seeing the commotion around the player it was clear there was more at stake. When the gravity of the injury became obvious, it was frightening. It got worse when the broadcast showed the reactions of the players. Not knowing a peer is going to be ok is very difficult for young healthy athletes to comprehend. It’s a completely foreign experience. I felt for the coaches. I thought of the parents and family of the player because I have dealt with so many injuries…there are so many people involved.”

Cardiovascular Technology

“What happened to Damar Hamlin on the field is a very rare case in sports medicine,” said Maria Mazalkova, MD, RDCS, Assistant Professor, Molloy University, Cardiovascular Technology, Department of Allied Health Sciences. “This [suspected] type of trauma is called Commotio Cordis which is a blunt trauma to the chest. That trauma had to occur in a very specific moment of the cardiac cycle to provoke a life-threatening arrhythmia sending the heart into cardiac arrest. If it happens at a different point in time, cardiac arrest will not happen. The only treatment needed in this case of cardiac arrest is CPR and defibrillation. We witnessed a very quick response by the medical team, and this led to successful cardiopulmonary resuscitation, and by the time Hamlin left the field, on his way to the hospital he already showed increased circulation which is a very positive sign.” 

The initial on field response and recognition of the severity of the injury is being cited as the reason for Hamlin’s survival. It this type of trauma happened away from trained personnel and necessary equipment the survival rate of cardiac arrest is less than 10%.

Molloy Athletics

“Athletic Trainers are the first staff who run on the field to help,” continued Zegers. “Usually the injuries are manageable, sprained joints and broken bones, not life and death; but the reality is you never know. There was no better example than what happened Monday. At Molloy we prepare, we practice, we review, and we learn from other instances and emergencies like this one in the NFL. We follow NCAA and New York State guidelines for appropriate medical care and emergency procedures for student-athletes. We have access to AED’s at all times. We have physicians on staff who attend games for sports with higher injury rates. Our coaches are certified in CPR and trained to use AED’s. We try to be ready for any situation to arise at any time.”

According to Zegers, Molloy has four full-time Athletic Trainers who attend all home games and most practices. All are certified by the National Athletic Trainers’ Association Board of Certification and the New York State Department of Education. Athletic Trainers are highly qualified, multi-skilled Allied Health Care Professionals who collaborate with physicians to provide preventative services, emergency care, clinical diagnosis, therapeutic intervention and rehabilitation of injuries and medical conditions.

Respiratory Therapy

Beyond the quick response, CPR, and use of an AED a significant contribution to Hamlin’s recovery was his intubation and the use of a mechanical ventilator. This process allowed his lungs to rest and heal from the traumatic experience.

“Respiratory Therapists play a major role in the health care field,” said Elaina Bongiovanni, Clinical Instructor, Molloy University Respiratory Care Department and Licensed Registered Respiratory Therapist. “They are part of the Care Team along with the doctor, physician’s assistant, nurse, and technicians. From the point the patient stops breathing, to the point the patient can breathe on their own, you will see the respiratory therapist at the head of the patient’s bed.

“After Mr. Hamlin went into cardiac arrest and was transferred to a Trauma Hospital a respiratory therapist was involved. Respiratory Therapists are licensed to work ventilators as well as intubate patients. Intubation is the method of placing a tube (artificial airway) into the trachea and placing the patient on a mechanical ventilator, this was performed on Mr. Hamlin. A mechanical ventilator is used when a patient cannot breathe on their own.  The ventilator will perform some portion, or all the work of breathing and delivers a variety of medical gas mixtures, including oxygen.

“Once the patient is stabilized, the “weaning process” can begin. With such a traumatic incident, the weaning processes must be done in a timely manner. The weaning process consists of lowering sedation and lowering the ventilator settings including oxygen. When first placed on a mechanical ventilator, they would give the patient 100% oxygen. The reason for giving 100% oxygen is to offset the time where he was in cardiac arrest and lost all that oxygen to perfuse to the tissue and organs.

“The signs the care team look for include vital signs, and neurological status. A patient’s neurological status is very important because the patient’s ability to breathe can be absent if there is severe neurological damage.

“When the patient is ready the breathing tube is removed, which is called extubating. First the Respiratory therapist will put the patient on CPAP. CPAP is a mode on the ventilator that makes them breathe on their own and if they tolerate it, then the respiratory therapist can extubate.  Once the patient can breathe on their own, and has no lung issues the respiratory therapist has done their job.”

Nursing

Once Damar Hamlin arrived at the hospital he was moved to the ICU. Ann Langan DNP, RN, NPD-BC, CCRN, Associate Professor, Molloy University, Barbara H. Hagan School of Nursing and Health Sciences, and Nurse Educator, North Shore University Hospital, prepares undergraduate Nursing students for work in the Intensive Care Unit in her class on critical care.

“Nurses working in the ICU typically are responsible for monitoring one or two patients,” shared Langan. “They are responsible for monitoring the patient wholistically looking at statistics plus things like skin appearance and position. It is a minute-to-minute process. Nurses provide essential information to the entire care team to assist in making interdisciplinary decisions regarding patient care.”

While the Hamlin incident is in the headlines, Langan reminds us that “cardiac arrest happens every day in our own backyards, on the ball field or even at a mall.”  Besides trauma other causes of cardiac arrest include coronary artery disease (in 80% of all cases), cardiomyopathies, structural heart diseases, and electrophysiological abnormalities. That is why CPR and AED training is so important.

“The situation that occurred during the Monday night football game is exactly why we provide the CPR training,” said Mary McCormack, DNP, FNP-C, Assistant Professor of Nursing, Molloy University, Barbara H. Hagan School of Nursing and Health Sciences.

“The Heart Safe Community team at Molloy University has been working diligently over the past two years empowering hundreds of individuals with the life savings skills of CPR and AED use. The incident that occurred during the Monday Night Football game is a perfect example of how well-orchestrated responses to sudden cardiac arrest can positively impact survival rates. We invite anyone interested in learning the lifesaving skills of CPR and AED use to contact us directly to arrange for free training (mmccormack1@molloy.edu).