MNF: Damar Hamlin

speedy

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I don't know that they can prove commotio cordis, but they can rule out a bunch of other things. Myocardial Infarction is the easiest to rule out because the blood work tells the tale. If it was a "clot" that would have certainly showed up as well. Perhaps they want to keep him on a monitor for a while to rule out any dysrythmias, but those usually present/leave clues as well. The odds of commotio cordis occurring are up there with hitting the lottery, but not impossible. I am surprised that in the history of the NFL, this is the first time it has occurred. I hope this dude plays again... Kinda of a funny story- just a couple hours before this happened, I was tossing a ball with my 2 boys. My 13 yr old threw me a heater when I was talking to the other and nailed me right in the center of the chest. I yelled out, "Holy R on T phenomena!!" They asked what that was and I told them a hard enough hit can stop the heart if it happens at a precise moment (R wave represents depolarization of the ventricles and the T wave represents repolarization- the absolute refractory period occurs in a tiny 1-2 millisecond window). 2 hours later this happens, and now my boys are thinking this is a common issue all the sudden hahaha. I had to assure them this was all just a crazy coincidence.
 

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The teams needs to make this man their MVP for the season. In all rights, Hamil should be dead right now but thanks to him he's not only alive but appears that he might recover. My doctor buddies thought for sure that he was going to be either brain dead or have massive brain damage if he survived. This is honestly shocking in the best way.
 
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This was my neighbor about 4 houses down around the corner before he got the Bills job. Had him and his family over for a couple neighborhood parties. Super nice guy and great family. Used to be the Head Athletic Trainer at SU.

Funny/ironic story - his daughter was swimming in our pool and struggled for a couple seconds. Denny runs over and pulls her out of the pool and his wife says “good job….. but not fast enough!!!!”.
 

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The odds of commotio cordis occurring are up there with hitting the lottery, but not impossible.

I'm confused by that. I read that there's about a 20 msec window. That's short, but if someone is exercising and their heart rate is elevated to, say, 100 bpm, then they're getting one complete beat every 600 msec. So that means a ballpark 1/30 chance of hitting the window, right? Is my math wrong?
 

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Going by medical terminology he died on the field and was brought back to life correct? I don’t think there’s anything that could ever significantly damage the NFL but that would’ve been as close as it gets.
 

speedy

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I'm confused by that. I read that there's about a 20 msec window. That's short, but if someone is exercising and their heart rate is elevated to, say, 100 bpm, then they're getting one complete beat every 600 msec. So that means a ballpark 1/30 chance of hitting the window, right? Is my math wrong?
The absolute refractory period lasts 1-2/1000’s of a second (within every beat, which usually last around a second, give or take). I’m not sure what exactly the odds are, but they’re not 1 in 30. I don’t think an elevated HR puts you anymore at risk than if your HR was in the 50’s. I had a pt about 15 yrs ago who this occurred to, and was told it was a super rare occurrence. The only other episode I know of is a young boy who took a baseball to the chest, and now this. Football players are no more at risk than a baseball player is. For all intents and purposes, this was a freak accident. If you look at the history of the league, all the games, all the plays, and this is the first occurrence.
 

elindholm

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The absolute refractory period lasts 1-2/1000’s of a second (within every beat, which usually last around a second, give or take).

Ah, okay. That's a lot less than 20 msec.

I don’t think an elevated HR puts you anymore at risk than if your HR was in the 50’s.

That's not what I meant. I was trying to estimate beat duration. Athletes exerting themselves on the field will have heart rates above 60, which means beats take less than a second, which means that there are more tiny windows to hit over a given time.

I had a pt about 15 yrs ago who this occurred to, and was told it was a super rare occurrence. The only other episode I know of is a young boy who took a baseball to the chest, and now this. Football players are no more at risk than a baseball player is.

Right, I'm just thinking, if someone gets hit hard exactly at that spot in the chest over and over, it seems like there's a decent probability that eventually one of those hits will be in the critical window.
 

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The behavior around the tackle is much worse than the act itself. Networks, people's lip service, over protective wokism, nauseating sensitivity for their benefit; at Hamlin's expense like a PC circus. People calling for people's job based on their political preference.
 

speedy

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Going by medical terminology he died on the field and was brought back to life correct? I don’t think there’s anything that could ever significantly damage the NFL but that would’ve been as close as it gets.
He didn't "die" on the field, but suffered a cardiac arrest. If left untreated, yes, he would have expired/died. I think boys playing a pickup game at the park are at far greater risk than an NFL player on a field with team doctors, trainers, and other staff on either side of the field. Nobody playing the game of football is at any greater risk of this happening than anyone else. We all have the 1-2ms period of "vulnerability" in our electrical phase.

I have witnessed quite a few cardiac arrests (meaning they happened right in front of me). I'd be talking to someone who is obviously sick, and they'd suddenly go into code status. We lay them down and deliver defibrillation as soon as possible. In most of the instances this has happened (right in front of me), we were able to quickly get them back ("return of spontaneous circulation," or "ROSC"). In some, we never did, because the underlying issue was more than just an electrical conduction issue we could rectify with a defibrillator and chest compressions. I'm not saying it is any event to be taken lightly, but from my perspective (Paramedic of >25 yrs), it was a situation that had a pretty straight forward remedy. I am sure the doctors and trainers were all spinning when the recognized his code status, but an otherwise healthy dude like that should get ROSC in a rather fast amount of time.
I am still perplexed why the ambo held up and waited on Mom. That didnt make much sense, unless they had a pulse and sufficient BP, and Doc realized what had happened (but still, that seemed really weird to me).
 

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This was a rare occurrence. When I was young teen I had a couple boxing lessons. I never forgot, someone asked about ways you can knock someone out. Did it always have to be on the jaw? The guy mentioned about 5 or 6 different ways, and ended with a punch to the chest. We were all in disbelief. "You mean like in the karate movies?" The trainer said something like, he saw a man's heart get stopped by a punch in the chest. When I heard what happened on MNF, I was like, that **** can happen!
 

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