Damar Hamlin incident puts spotlight on commotio cordis and CPR AED response

After the event with Damar Hamlin, Commotio Cordis was thrust into the spotlight. Doctors across the country feel that this, among other things, is what caused his collapse. This also highlights the need of CPR training in responding to these types of emergencies.

On Jan. 2 2023, a routine tackle in an NFL game nearly became fatal when Damar Hamlin of the Buffalo Bills was hit in the torso during a play, resulting in cardiac arrest.

Hamlin fainted unexpectedly after a brief celebration after the play. Within seconds, the Paycor Stadium went from a loud crowd to hear a pin drop as Hamlin lay motionless on the ground, requiring emergency external defibrillation to restart his heart.

This appears to have all of the hallmarks of “commotio cordis”. The NFL's chief medical officer stated this is a possibility, but doctors are looking at all possibilities.

What is commotio cordis?

Commotio cordis is the result of blunt trauma to the heart and is one of the leading causes of sudden cardiac death in contact sports.

Commotio cordis produces ventricular fibrillation, which leads to pump failure. Although uncommon, unless rapid resuscitation is performed, this condition is lethal. Despite the usage of chest armor, commotio cordis still happens.

Survival rates have increased over the years, but commotio cordis is still often fatal.

Research shows that commotio cordis occurs when the following conditions are present, The impact must occur over or around the heart, the impact speed ranges from 48 to 80 kph (30 to 50 mph), and the impact occurs during the vulnerable period of the cardiac cycle which is approximately 20 milliseconds in length, just before the peak of the T-wave on an electrocardiogram.

What is the initial response when this happens?

CPR.

The most crucial aspect of treatment is to keep oxygen flowing to the heart and brain by beginning CPR as soon as possible. If the heart is in ventricular fibrillation, an electric shock could restore normal rhythm.

The faster an athlete's heart can be electrically restarted using a device such as that an AED, the greater the chances of survival.

An automated external defibrillator (AED) is a portable electronic device that can detect and treat life-threatening cardiac arrhythmias ventricular fibrillation (VF) and pulseless ventricular tachycardia (PVT).

According to some research, the death rate from "commotio cordis" is greater than 70%. Outside of the hospital, the fatality rate after a cardiac arrest is closer to 90%.

However, when CPR is administered promptly, the higher chances of recovery are.

Attending CPR AED training is a critical first step toward acquiring the necessary knowledge and skills to prepare for these kinds of events.

Sources

https://theconversation.com/damar-hamlin-injury-was-it-commotio-cordis-how-to-prevent-a-potentially-fatal-blow-to-the-heart-in-young-athletes-197268

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