Opinion: 3 takeaways from doctors about Damar Hamlin's cardiac arrest and resuscitation

• Dr. Nick Kluesner is an emergency physicians with UnityPoint Health-Des Moines.
• Dr. Matt Trump works in pulmonary and critical care medicine with UnityPoint Health-Des Moines and The Iowa Clinic.
• Dr. Carlos Pelaez is a trauma surgeon with UnityPoint Health-Des Moines and The Iowa Clinic.

Most of the public is aware of the dramatic events on Monday Night Football in early January when Buffalo Bills football player Damar Hamlin suffered a cardiac arrest from a tackle and received on-field CPR and defibrillation with the entire crowd and teams watching before being taken by ambulance to the nearest Level I Trauma Center. As your local physicians specializing in emergency medicine, trauma and critical care, we shared several reflections regarding these visible circumstances that we felt could be valuable for the public.

First, and foremost, this is an occasion to celebrate what appears to be the wonderful recovery of Mr. Hamlin and the excellent medical care he received from the on-field medical team, the EMS personnel who transported him to the hospital, and the emergency, trauma and critical care teams that took care of him in the hospital. His very public medical care clearly highlights the best that medicine can offer. The EMS and hospital care delivered to Mr. Hamlin exist in nearly every community, and those individuals here in Iowa remain vigilant, continuously train and are prepared for just such an occurrence. 

There are a few additional perspectives, as health care professionals, that we wanted to highlight in addition to this celebration for Mr. Hamlin and his health care teams.

Cardiac arrest is often fatal

Mr. Hamlin’s outcome seems to be excellent, cited as “neurologically intact,” but the public should understand that it was likely a product of his baseline health, his unique injury and the immediate deployment of highly trained medical personnel who were ready and waiting just a few yards away. 

The real rate of out-of-hospital cardiac arrest positive outcomes like Mr. Hamlin’s is less than 6%.

This is not a reality most people recognize; in fact, there is some illuminating literature showing the dramatic disparities between cardiac arrest survival on TV compared to reality. So, while we should not expect the same miracle for ourselves; we can and should use Mr. Hamlin’s story as motivation to learn CPR and locate your nearest AED. They do work! (Just understand that most of the time it may not result in a positive outcome.)

Resuscitation is messy

There have been calls to not circulate videos taken of his on-field resuscitation out of respect for Mr. Hamlin’s privacy in such a vulnerable moment and because of the gruesome visuals it provides.  While we certainly should respect the importance of privacy, the public should also better recognize that resuscitation from cardiac arrest is a very graphic procedure.  It can appear downright violent between chest compressions and defibrillation.  Outcomes of CPR depicted on TV or in movies aren’t just romanticized; so too is the procedure itself. It is worth understanding both realities as your doctor discusses your preferred "code status." Educational videos for patients exist and can be offered to patients so that they truly understand the resuscitation procedure before agreeing to it.

Medical workers are resilient

Lastly, as the scene unfolded on the field, the emotional, horror-stricken faces of the other professional athletes was telling. They were so traumatized by watching the brief, successful resuscitation that the game was canceled. Rightly so. It is a tragic and distressing thing to see.  Health care workers, however, attend much more prolonged, gruesome and less successful resuscitations, and yet, after taking a brief breath, walk into the next room to address another patient’s needs with care. And we do this every day. We hope through these events, the public has gained more compassion for the human experiences of their health care team.

To summarize, in addition to the outpouring of support for Mr. Hamlin and his charity, and the celebration of his excellent medical care, we hope the publicity of these events gives the public motivation to learn CPR, an occasion to explore advanced directives with their primary care providers and understanding for the work the health care teams do to support our community members.

Dr. Nick Kluesner is an emergency physicians with UnityPoint Health-Des Moines. Nick Kluesner is an emergency physician with UnityPoint Health-Des Moines. Dr. Matt Trump works in pulmonary and critical care medicine with UnityPoint Health-Des Moines and The Iowa Clinic. Dr. Carlos Pelaez is a trauma surgeon with UnityPoint Health-Des Moines and The Iowa Clinic.