Week 17 Games

[Trudge]

He been in care for 15 hours, not even. Holy &%$@ give him time.

[NCF]

I have to believe that with the attention from trainers within 15 seconds that he was given CPR as soon as it was needed. A human can go up to 4 minutes without breathing before brain damage occurs. That leads me to think that brain damage is unlikely and he will make a complete recovery.

I wouldn't have my hand up to put that to the test.

[AmishMafia]

I have to believe that with the attention from trainers within 15 seconds that he was given CPR as soon as it was needed. A human can go up to 4 minutes without breathing before brain damage occurs. That leads me to think that brain damage is unlikely and he will make a complete recovery.

I wouldn't have my hand up to put that to the test.

Me neither. Friend of mine spent a good 2 minutes under water. They resuscitated him and he was fine. And that was with a couple of drunk shmendricks doing cpr for the first few minutes. How much better are Damar's chances? Not 100% but i would think fairly good. But as [mention]BSA[/mention] points out, everyone is different and there is no way of knowing. That Damar is young and in great physical conditioning should be working in his favor as well

I also tend to be very optimistic.

[AmishMafia]

A human can go up to 4 minutes without breathing before brain damage occurs.

Medicine is often a continuum and it varies across patients. Perhaps a more accurate version that statement:

Some humans can sometimes go up to 4 minutes without breathing before measurable brain damage occurs
Other humans will have measurable brain damage without breathing for as little as 2-3 minutes. Generally speaking, brain damage ( cell death) begins at the 1 minute mark, steadily worsening from there on.

Initiation of CPR does not restore full oxygen perfusion to the brain and the body's response to the O2 deprivation will lead to other body parts getting less as the body literally "pulls" oxygen out of other organs to feed the brain. Its an evolutionary response to preserve life. Those other organs are negatively impacted by the oxygen deprivation as well.

I doubt we know the full extent of the initial injury and subsequent trauma for several days, probably longer. Intubation and sedation are not atypical in treating cardiac arrests, so I wouldn't read anything into those procedures at this point.
Fingers crossed there are no serious long term issues for this young man.
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I'm not a Healthcare professional or anything but here is what I was thinking - oxygen saturation is 95% - 100% in the body. Although only a fraction of circulated blood goes through the lungs on any given loop. Therefore the cells only uses a small % of the oxygen in the blood. Therefore, if you stop breathing and the circulatory system I still working, the cells still have enough oxygen for a period of time. How much time? Well some skin divers hold there breath for over 2 mins with no discernable ill effects. Pearl divers do it for years and appear okay.

So the question would be, how well does chest compressions move blood? My understanding is that it does an adequate job.

Anyway, you seem to know about medicine - does thus make sense? Is there a flaw in my reasoning?

[Yoop]

If you hold your breath for too long it can cause your heart to start beating irregularly. It can damage your kidneys and liver. Holding your breath also causes the amount of carbon dioxide building up in your body to cross the blood-brain barrier.

thing is a Pulmonary DR will put you on Oxygen if your levels fall below 90 sat oxy level, so if your not breathing for 3 to 4 minutes I don't know how that wouldn't happen, I've heard of people that snorkel and do that having heart attacks and strokes, same with deep sea divers.

[BSA]

So the question would be, how well does chest compressions move blood? My understanding is that it does an adequate job.

They recently changed the CPR training directive to eliminate the breathing component, just do the compressions. Too many people were doing CPR wrong and too often when they stopped compressions to blow air in, the patients had a worse outcome. So they changed the training because their research suggested CPR compressions alone are adequate for a resting body until professional help arrives.
Breathing + compressions is better- but only if you know what you're doing.

At the time of the accident, Hamlin was operating at peak performance and his muscles were using a huge amount of energy and oxygen.
In that scenario, the compressions alone wouldn't be as effective. And you need to get the blood flow all the way deep into the brain capillaries.
The adrenaline release post-injury will help by opening up the various blood vessels as the body prepares for fight/flight.
The release of Troponin tells the body its a cardiac event, all hands on deck.

Its all a delicate balance ( our lives depend on it !) with dozens of checks and balances - but the sudden stop of circulation changes everything and the CPR hand-compressions will quickly become inadequate for an athlete in the middle of an NFL game. Note how players are huffing & puffing at the end of each play - because their muscles are clamoring for more oxygen and it takes time to get caught up. So that's where Hamlin was when he got hit, in oxygen debt. Using compressions alone to overcome that debt is a big ask.

Since they wouldn't be able to intubate at the stadium, that procedure happened at the hospital after he was sedated.

Pretty wide range of outcomes here - but he's young, in great shape and getting the best care possible.

Also - the divers who train for this specific scenario learn how to overcome it through various breathing exercises as they slow everything down- but they are mostly stationary and not in full exertion like an NFL player. Completely different oxygen demands. I don't think these divers could ride a stationary bike while holding their breath for several minutes, but that's conjecture on my part.
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[APB]

to your entire post [mention]BSA[/mention] but I must question this:

Since they wouldn't be able to intubate at the stadium, that procedure happened at the hospital after he was sedated.

ALS ambulance crews intubate in the ambulance or on scene all the time. I’d be shocked if the stadium didn’t have an ALS crew as their stadium standby crew. That, and the team doctors are also capable and equipped, I would assume…?

I didn’t see footage of Hamlin being loaded into the ambulance on the playing field nor at the hospital but wouldn’t be at all surprised if he arrived at the trauma center “tubed”.

Was it reported he wasn’t intubated until arrival at the hospital? If he wasn’t, I’d be asking “why not?” if they were aware of the cardiac/circulatory issue.

[BSA]

ALS ambulance crews intubate in the ambulance or on scene all the time.

I didn't know that, thanks for illumination.
And that certainly changes the timeline in Hamlin's favor.

[APB]

ALS ambulance crews intubate in the ambulance or on scene all the time.

I didn't know that, thanks for illumination.
And that certainly changes the timeline in Hamlin's favor.

My helo crews are all ALS (Advanced Lifesaving) qual’d and they intubate in the back of the helo quite regularly.

[Yoop]

Hamlin fell at 8:53 p.m. and remained down for more than fifteen minutes. He was given oxygen, placed on a stretcher, hooked up to an IV and eventually carried into an ambulance that had entered the field. The ambulance remained in the tunnel as Hamlin's mother made her way down from her seat in the stands.

[APB]

Hamlin fell at 8:53 p.m. and remained down for more than fifteen minutes. He was given oxygen, placed on a stretcher, hooked up to an IV and eventually carried into an ambulance that had entered the field. The ambulance remained in the tunnel as Hamlin's mother made her way down from her seat in the stands.

If they were actively performing CPR, I’d be absolutely shocked they would await the arrival of the mother before proceeding to the hospital. I’d have to assume Hamlin’s heartbeat and breathing had somewhat recovered for that delay in transport to advanced care at UC to have occurred.

[Yoop]

Hamlin fell at 8:53 p.m. and remained down for more than fifteen minutes. He was given oxygen, placed on a stretcher, hooked up to an IV and eventually carried into an ambulance that had entered the field. The ambulance remained in the tunnel as Hamlin's mother made her way down from her seat in the stands.

If they were actively performing CPR, I’d be absolutely shocked they would await the arrival of the mother before proceeding to the hospital. I’d have to assume Hamlin’s heartbeat and breathing had somewhat recovered for that delay in transport to advanced care at UC to have occurred.

I can't find it, but another report I read said he regained consciousness prior to being put in the ambulance, but didn't say how long he was unconscious, but I expect as you do that he was able to breath and his heart was beating on it's own, doesn't mean he doesn't have some permanent damage though.

[AmishMafia]

So the question would be, how well does chest compressions move blood? My understanding is that it does an adequate job.

They recently changed the CPR training directive to eliminate the breathing component, just do the compressions. Too many people were doing CPR wrong and too often when they stopped compressions to blow air in, the patients had a worse outcome. So they changed the training because their research suggested CPR compressions alone are adequate for a resting body until professional help arrives.
Breathing + compressions is better- but only if you know what you're doing.

At the time of the accident, Hamlin was operating at peak performance and his muscles were using a huge amount of energy and oxygen.
In that scenario, the compressions alone wouldn't be as effective. And you need to get the blood flow all the way deep into the brain capillaries.
The adrenaline release post-injury will help by opening up the various blood vessels as the body prepares for fight/flight.
The release of Troponin tells the body its a cardiac event, all hands on deck.

Its all a delicate balance ( our lives depend on it !) with dozens of checks and balances - but the sudden stop of circulation changes everything and the CPR hand-compressions will quickly become inadequate for an athlete in the middle of an NFL game. Note how players are huffing & puffing at the end of each play - because their muscles are clamoring for more oxygen and it takes time to get caught up. So that's where Hamlin was when he got hit, in oxygen debt. Using compressions alone to overcome that debt is a big ask.

Since they wouldn't be able to intubate at the stadium, that procedure happened at the hospital after he was sedated.

Pretty wide range of outcomes here - but he's young, in great shape and getting the best care possible.

Also - the divers who train for this specific scenario learn how to overcome it through various breathing exercises as they slow everything down- but they are mostly stationary and not in full exertion like an NFL player. Completely different oxygen demands. I don't think these divers could ride a stationary bike while holding their breath for several minutes, but that's conjecture on my part.
.

Makes sense. Thanks for the info!

[Trudge]

Hamlin fell at 8:53 p.m. and remained down for more than fifteen minutes. He was given oxygen, placed on a stretcher, hooked up to an IV and eventually carried into an ambulance that had entered the field. The ambulance remained in the tunnel as Hamlin's mother made her way down from her seat in the stands.

If they were actively performing CPR, I’d be absolutely shocked they would await the arrival of the mother before proceeding to the hospital. I’d have to assume Hamlin’s heartbeat and breathing had somewhat recovered for that delay in transport to advanced care at UC to have occurred.

They said on ESPN that they had the heart paddle things that George Cloony uses, or something along those lines.

[Scott4Pack]

Hamlin fell at 8:53 p.m. and remained down for more than fifteen minutes. He was given oxygen, placed on a stretcher, hooked up to an IV and eventually carried into an ambulance that had entered the field. The ambulance remained in the tunnel as Hamlin's mother made her way down from her seat in the stands.

If they were actively performing CPR, I’d be absolutely shocked they would await the arrival of the mother before proceeding to the hospital. I’d have to assume Hamlin’s heartbeat and breathing had somewhat recovered for that delay in transport to advanced care at UC to have occurred.

They said on ESPN that they had the heart paddle things that George Cloony uses, or something along those lines.

The AED was put into use while he was still on the field. That would’ve given him “shocks” to stimulate/regulate the heart beat, and give verbal instructions to assist the care-givers (not that those professionals required any verbal assistance from a machine).

[BF004]

Hamlin fell at 8:53 p.m. and remained down for more than fifteen minutes. He was given oxygen, placed on a stretcher, hooked up to an IV and eventually carried into an ambulance that had entered the field. The ambulance remained in the tunnel as Hamlin's mother made her way down from her seat in the stands.

If they were actively performing CPR, I’d be absolutely shocked they would await the arrival of the mother before proceeding to the hospital. I’d have to assume Hamlin’s heartbeat and breathing had somewhat recovered for that delay in transport to advanced care at UC to have occurred.

They said on ESPN that they had the heart paddle things that George Cloony uses, or something along those lines.

One of the worst misconceptions on TV, defibrillators are used to stabilize an irregular heart beat. They are never used and don’t work to restart an unbeating heart.

[BSA]

.
Here's a graphic showing all the different medical personnel at an NFL game, including an Airway Management Physician who can intubate in the stadium. That's literally a life saver

[Yoop]

If they were actively performing CPR, I’d be absolutely shocked they would await the arrival of the mother before proceeding to the hospital. I’d have to assume Hamlin’s heartbeat and breathing had somewhat recovered for that delay in transport to advanced care at UC to have occurred.

They said on ESPN that they had the heart paddle things that George Cloony uses, or something along those lines.

One of the worst misconceptions on TV, defibrillators are used to stabilize an irregular heart beat. They are never used and don’t work to restart an unbeating heart.

Trudge said Paddles, as in electric shock, I said defibrillator, because thats what the article said, either way his heart was beating on it's own prior to being put in the Ambulance according to that article, thing is as APB said, they wouldn't have hung around for roughly 40 minutes waiting on his Momma if he wasn't breathing on his own and had a strong heartbeat, to me it sounds as though the medical team on the field saved Hamlins life with a quick response, got his heart beating, there isn't even a mention of intubation, so that may have not been needed

this doesn't mean though that Hamlin is not going to have long lasting affects from this, to early to tell

[BF004]

They said on ESPN that they had the heart paddle things that George Cloony uses, or something along those lines.

One of the worst misconceptions on TV, defibrillators are used to stabilize an irregular heart beat. They are never used and don’t work to restart an unbeating heart.

Trudge said Paddles, as in electric shock, I said defibrillator, because thats what the article said, either way his heart was beating on it's own prior to being put in the Ambulance according to that article, thing is as APB said, they wouldn't have hung around for roughly 40 minutes waiting on his Momma if he wasn't breathing on his own and had a strong heartbeat, to me it sounds as though the medical team on the field saved Hamlins life with a quick response, got his heart beating, there isn't even a mention of intubation, so that may have not been needed

this doesn't mean though that Hamlin is not going to have long lasting affects from this, to early to tell

Just depends, we haven't been given any info. From my limited medical knowledge, an arrhythmia or irregular heartbeat could obstruct blood going to the brain (cause someone to collapse). In which case a defibrillator would be the tool of use. If the heart stopped, CPR would be used. Maybe both were, not sure if that is common, possible, impossible, for both to happen in a short window like that.

Just making the point movies get it wrong all the time whenever they bust out the shock paddles for one who needs their heart to reboot.

[Raptorman]

So if the 5 minutes came from the NFL, it didn't come from the front office.