Adopting Greater CPR Strategies After Damar Hamlin

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Michael J. Ackerman, MD, PhD, discusses the simplicity and availability of education around CPR and defibrillator use, and the role of clinicians in raising public health preparedness.

Buffalo Bills football player Damar Hamlin collapsed during a matchup against the Cincinnati Bengals on Monday Night Football during this week, suffering a cardiac arrest that necessitated life-saving cardiopulmonary resuscitation (CPR) and automated external defribillator (AED) shock on the field as thousands of in-person fans and millions of at-home viewers watched on.

As Hamlin continues a recovery from his critical but stable condition 2 days later, discussion among health care professionals has spanned from diagnostic speculation to forward-looking discussion: what is known about cardiac arrest-causing conditions and what happened to Hamlin that may inform his health outlook going forward?

Perhaps a sentiment lost in this seminal moment of a public medical emergency is the opportunity it provides to educate the public on how to save a life like responders saved Hamlin’s on Monday night.

In the second segment of an interview with HCPLive, Michael J. Ackerman, MD, PhD, director of the Mayo Clinic Windland Smith Rice Genetic Heart Rhythm Clinic and the Windland Smith Rice Sudden Death Genomics Laboratory, as well as president of the Sudden Arrhythmia Death Syndromes (SADS) Foundation, discussed the little-known simplicity of administering CPR and AED care to a cardiac arrest patient.

Ackerman emphasized the widespread, time-efficient and hugely beneficial availability of CPR training from various health organizations and programs. He added that AED administration is a similarly simplistic and hugely necessary practice for patients in need of emergency resuscitation from their first responder. In fact, he cited a recent study showing sixth graders could apply, read, and administer care via standard AED tools within 60 seconds—a speed similar to train professionals.

“In other words, these are not hard—but there needs to be the Boy Scouts, Girl Scouts, ‘Be prepared’ drill,” Ackerman said.

Ackerman additionally encouraged persons who may be affected by Hamlin’s cardiac arrest to visit or the Mayo Clinic site to find resources around CPR and AED training.

Regarding his clinician colleagues, Ackerman said he hopes they use this moment in public health discussion to consider a more nuanced role as their community’s “ambassador” for cardiac event preparedness; he suggested they consider a pain of hypothetical questions, “How hard is it to die suddenly in my community? And what is our state of readiness if somebody went down in our town square?”

In further emphasizing the need for preparedness, Ackerman stressed that there is a clear interpretation of cardiac event risk—and with it, a plan—for thousands of his genetically-affected patients. Generally for these patients, a 10-second period after a collapse wherein they are unconscious and unresponsive is cause to initiate calls for help and chest compressions.

Even for patients without preconceived risk—such as Hamlin—the protocol is similar. “[The athletic trainers] went into action very fast—and there’s no downside to activating 9-1-1 sooner and having it not be necessary,” Ackerman said. There’s no downside, aside from sore ribs, from starting chest compressions right away if you didn’t need it.”

Regarding Hamlin, Ackerman said he’s personally awaiting for more information to be made around how immediate care was administered, and the player’s response to it, before weighing in on any diagnostics.

“There’s information there, from a detective work,” he explained. “There’s certain genetic heart conditions where 5 minutes into it, one shock and you’re back. There are others where if there’s shock after shock after shock, that takes you down a different road of what might be the why.”

In the interim, the upsetting public event served not only as a reminder of the importance of emergency health preparedness, but the significance of life itself.

“Life is precious. Life is fragile,” Ackerman said. “And preparedness is a really important thing for all of us as we navigate the twists and turns life throws at us.”