A group of about 40 participants in a recent training session at the OSF HealthCare Athletic Training Center at Illinois State University braved high humidity in the domed field to get a refresher on emergency procedures for medical emergencies during high school practices or sporting events.

As part of a collaboration, athletic trainers from ISU and OSF HealthCare gave high school trainers and master’s degree students from ISU’s Athletic Training program a refresher on critical skills. The timing was planned to be aligned with the start of practices and the Illinois High School Athletic Association (IHSA) sports season on August 11.

Joe Whitson, former athletic trainer and OSF HealthCare manager of the office that provides physician athletic trainers, says they simulated some of the most common conditions trainers see on the field.

“We had various stations going on, whether it was splinting and spine boarding, treatment of the spine-injured athlete. Dr. Rai, one of our sports medicine physicians, was here as well to help supervise. He was here giving pointers, walking around the stations, also working with our athletic trainers, giving them pointers and tips on skills that they can utilize out in the clinical field.”

OSF provides athletic trainers to seven local high schools, which were represented in the training. Whitson says the training helped reinforce how to identify symptoms of various conditions.

“Hitting tips on hydration, hitting tips on how to recognize the difference between sickle cell anemia, heat stroke and rhabdomyolysis. Unfortunately, with the increase in high school participation, high school athletes participating in sports, obviously, the incidence of these types of episodes are increasing as well.”

Rhabdomyolysis is a serious condition where damaged muscle tissue breaks down, releasing its contents into the bloodstream.

Whitson says every year there are headlines of student athletes who have issues and are admitted to the hospital due to some of these conditions, so it was important to go over related symptoms and emergency procedures, not only to know how to respond, but also how to prevent medical emergencies.

High school athletes want to perform at their highest level, and in many cases, they’re pushing for a college scholarship, so Whitson says it’s important for coaches to have support from medically trained professionals.

“That’s really a benefit that we've been able to provide here at OSF within the community, to be able to have those athletic trainers as resources, so that the coaches at all of our high schools have a resource to be able to lean on that’s clinically and medically trained to be able to handle those types of situations.”

The training emphasized communication as participants switched off playing roles, serving either as the lead practitioner, a medical assistant or the athlete. The training even highlighted infant CPR in case of a situation that might occur in stands.

Whitson stresses the IHSA has put safety standards into place to prevent injuries and medical emergencies and he says athletic trainers provide education around those protocols.

“The athletic directors obviously are in charge and kind of house enforcement of some of those things for student athlete safety. And that's the great thing where these athletic trainers from OSF, are able to come in and be able to educate the athletic directors, the student athletes, the coaches, and give those speaking points that are critical to be able to take care of them.”

ISU’s athletic training department has been hosting emergency training events for several years to make sure its staff is ready to handle emergencies that arise. This year, under a new collaboration with OSF HealthCare, it was the first time it was open to other community members.

Joe Whitson

B-roll for OSF-ISU train the trainers for medical emergencies

She was about to become a statistic in a polio epidemic and battle a disease that still impacts her in 2024.

Though polio is nearly eradicated today thanks to childhood vaccinations, both the disease and the shots have garnered headlines lately. This month, Paul Alexander, who spent much of his life in an iron lung, passed away at age 78. And the state of Illinois is combating a measles outbreak, reminding us of the importance of vaccines.

Kemnetz’s story

Kemnetz says the week she got her headache that led to a polio diagnosis was a painful blur.

“All my senses were on high alert,” she says. “The littlest sound was like somebody stomping next to my ear. We had a little night light. I couldn’t even stand to have it on.”

On Sunday, the family doctor made a house call and immediately called for an ambulance. Kemnetz wound up at Mercy Hospital in Urbana, Illinois (now OSF HealthCare Heart of Mary Medical Center). That next month, she says, was also a blur. Among other things, doctors upon her arrival performed a spinal tap to examine Kemnetz’s spinal fluid. She also recalls waking up one day with doctors preparing to put her in an iron lung to help her breathe.

“I screamed at my parents not to put me in that. I was terrified,” Kemnetz says.

After leaving the hospital, Kemnetz got more treatment near her home before spending over a year at a hospital in New York. There, she reprogrammed her leg muscles to work through repetitious exercises. It’s what we know today as physical therapy. Eventually, she returned to a mostly normal life and a career in real estate.

Polio then vs. now

Albert England, MD, an infectious disease physician at OSF HealthCare, says polio has been around “for a long time.” There’s even evidence of ancient Egyptians having it, he says. The disease is caused by a virus that “invades the nervous system and can cause total paralysis in a matter of hours,” according to the World Health Organization (WHO). Other symptoms are flu-like, including fever, difficulty breathing, fatigue, headache, vomiting, a stiff neck and pain in the arms or legs.

Dr. England says today, doctors use ventilators to help sick people who can’t breathe. But back in 1952, the iron lung – which Kemnetz got acquainted with – was the help available for people with polio.

“It produced negative pressure around the patient, allowing the lungs to expand and contract regularly,” Dr. England explains.

“It was like having CPR 24/7,” Kemnetz says of lying in the tube. “So uncomfortable.”

Kemnetz also gave blood to help develop a polio vaccine, the number one way we have come to fight that disease and many others. It’s a topic she’s passionate about today.

“We have to save the children,” she says.

The United States Centers for Disease Control and Prevention (CDC) says children should get four doses of the polio vaccine as a part of routine childhood vaccinations. The CDC says while it’s rare, adults who know or suspect they did not get the shots as kids should get them as adults. Adults who are at an increased risk of getting the disease, such as working in a laboratory where the virus may be present, can get a booster shot.

“The vaccine prevents illness by developing antibodies,” Dr. England explains.

Kemnetz today

In 1985, Kemnetz developed post-polio syndrome, a disorder that weakens the nerves and muscles. She says her hands “look nice,” but everyday tasks like writing, eating or shuffling cards are tough.

“There are just not as many neurons providing the strength the people need,” Dr. England says of post-polio syndrome.

But, after being told in 1952 that walking, having children and living a long life was unlikely, Kemnetz is counting her blessings. Among them are the chances to recount her life story with her children and grandchildren.

“I think I thumbed my nose at them pretty good,” she quips about her prognosis back then. “The word ‘can’t’ isn’t in my vocabulary.”

Interview clips

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When talking about the opioid crisis in America, you don’t have to explain much to Howard Marsh.

A first responder for nearly a half century, Marsh has gone on numerous ambulance calls for a suspected overdose.

“It breaks my heart,” says the Advanced Medical Transport paramedic. “I just can’t believe people do this to their bodies.”

New federal data show nearly 108,000 people died of an overdose in 2022. That's up slightly from 2021. It’s a time to know the facts and misconceptions about overdoses, their causes and ways to reverse the deadly effects. One such way is naloxone, known under the brand name Narcan, a medication that has become more available in recent years to both first responders and everyday citizens.

“It’s really a good drug to have around,” Marsh says.

Narcan basics

Les Mennenga is lead educator for East Central Illinois Emergency Medical Services (EMS), an OSF HealthCare organization that trains ambulance workers. He describes Narcan as an opioid antagonist that helps reverse the effects of dangerous drugs like fentanyl, morphine, heroin and Tramadol.

“If we get too much of those medications in our system, they’ll bind with receptor sites in our brain. They’ll slow our breathing and pulse rate down,” Mennenga says. “They can actually stop the signal to our diaphragm and make us stop breathing.”

Conversely, he says, “Narcan gets to those receptor sites, competes with the opioid and will knock it off. It will help the person restore their breathing.”

Mennenga says Narcan does not work with methamphetamine, cocaine and other non-opioids.

At the scene of a suspected overdose, typically the first bits of information come from friends or family of the ailing person. Those people likely know if the person has a history with a certain drug, for example. First responders will also look for drug paraphernalia like needles. Mennenga says if the person is still alert and breathing, they would not qualify for Narcan.

“The only time we should be administering Narcan is if they’re having difficulty breathing,” Mennenga says. “They’ll be unresponsive, snoring-like respirations or not breathing at all.”

Blue lips are another sign, Marsh says.

There are three ways to give Narcan: through a shot into the muscle; intravenous therapy, commonly known as an IV; and the most common and simple way, Mennenga says, is a nasal spray. Mennenga adds that Narcan may be combined with cardiopulmonary resuscitation (CPR) or a bag valve mask to help restore breathing.

Mennenga says once the person comes to, they might experience withdrawal symptoms like nausea, vomiting or, in rare cases, a seizure or heart issues. First responders will provide more care as needed.

“Go to the hospital and get checked out,” Marsh advises. “We prefer we take you in case something happens in route.”

What you should know

East Central Illinois EMS has rolled out a Narcan leave behind program. The agency provides kits for first responders to leave with friends, family and others after responding to an overdose. The program serves as a reminder that this is an important issue. Experts say survivors are at high risk for repeated overdoses, and Narcan may be the only chance to save their life.

“Overdoses are quite common, unfortunately,” Mennenga says. “Nobody’s immune to the opioid crisis.”

He says if you want a supply of Narcan at home, contact your local health department for options.

Mennenga also says Narcan, shockingly, has some detractors. He says some people think opioid users need to learn the consequences the hard way. But Mennenga, a veteran of the EMS world, says many people who suffer overdoses aren’t your stereotypical drug user. Their use might have started with an injury, leading to pain medication. Or older adults often mix up pills and take too many.

“If they really want to get some help, we can give them resources like their public health department or the state public health department,” Mennenga says.

Learn more

Websites for the U.S. Centers for Disease Control and Prevention, the Substance Abuse and Mental Health Services Administration, the Illinois Department of Public Health and the Michigan Department of Health and Human Services all have information on opioid addiction, treatment and recovery. If you are in crisis, the national Suicide and Crisis Lifeline is 9-8-8.

Interview clips - Les Mennenga

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Bronny James was gearing up last summer for his freshman year of basketball at the University of Southern California, when he received the scare of his life.

In July 2023, James, the son of NBA great LeBron James, suffered cardiac arrest and collapsed during a team workout. The younger James was hospitalized for three days and underwent a procedure to treat a congenital heart defect. James’ family and medical team praised the USC medical staff for their quick and effective response, which helped in preventing any brain or organ damage from a lack of oxygen.

James eventually returned to basketball activities. He saw his first action for USC in December and has played anywhere between 14 and 30 minutes a game without any issues.

February is American Heart Month – a time to bring to light conditions such as the one James experienced that may help other people going through similar circumstances.

Natasha Noel, MD, a pediatric cardiologist with OSF HealthCare Cardiovascular Institute, says congenital heart defects, such as the one James had treated, are structural heart issues that typically develop during pregnancy and go undetected. She adds that 1% (40,000) of all babies are born with a heart defect every year in the U.S.

“We do see that if there is a family history of congenital heart disease, either parent or sibling, the next child could be more at risk for congenital heart defects,” Dr. Noel says. “And then other conditions, for example, smoking during pregnancy, maternal diabetes or use of other medications during pregnancy can lead to congenital heart defects.”

While James has recovered from his heart scare, there have been other athletes who weren’t so fortunate. In 1990, Hank Gathers, a college player for Loyola Marymount University, collapsed on the court and died from of sudden cardiac arrest. Three years later, the same happened to Reggie Lewis of the Boston Celtics, who died during a game when his heart went into cardiac arrest.

James isn’t even the first player to have experienced cardiac arrest at USC. Teammate Vince Iwuchukwu collapsed during a team practice in 2022 and survived.

“During periods of intense activity, the body has a physiological response,” Dr. Noel explains. “This can include dehydration, a surge of adrenaline, electrolyte imbalance, and this may not be well tolerated in athletes, who have some underlying electrical or structural abnormality.”

Treatment depends on the patient and the heart defect. According to the American Heart Association, many young adults who have a minor cardiac defect, and have had a good result after surgery, can participate in most activities. Some participants could have restrictions including those with pacemakers or implantable cardioverter defibrillators (ICDs) or those who are taking anticoagulants to decrease blood clotting. Dr. Noel says to always check with your physician before taking on any physical activity or sports participation.

“The athlete should go through a pre-participation physical, this would include medical history, physical exam, and the American Heart Association says it’s important to look at personal and family history,” she says. “If there is something suspicious in any of these things, the pediatrician can refer to a pediatric cardiologist or they could start the work themselves, which would include ordering an EKG or echocardiogram for an example.” Genetic testing might be necessary, especially if there is a family history.

Dr. Noel says that thanks to advances, medical experts have a better understanding of congenital heart defects. Not every athlete needs to give up participation – even if they have experienced a previous issue. She also stresses the importance of learning CPR and working with schools and coaches to always have an automated external defibrillator (AED) available.

“I want to encourage kids to continue going out and having fun – sports is healthy and it's exercise,” she emphasizes. “It doesn't mean that it's the end of the world if you are diagnosed with something that needs to be treated from a cardiac standpoint.”

For more information about pediatric cardiology issues, visit OSF HealthCare. 

 

Interview Clips 

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“I pour coffee, help the waitresses and hostesses, bring out food,” Lindsey describes.

“I make sure everybody’s happy,” he adds warmly.

But on October 6, 2023, just steps away from the restaurant, Lindsey would have a life-changing moment. He says one minute, he was in a vehicle with his cousin. The next, he was waking up in the hospital.

In between, a good Samaritan who happened to be across the street saved Lindsey’s life, thanks to skills learned at OSF HealthCare and an alert from a smartphone app that OSF brought to Champaign.

“I’m very grateful,” Lindsey says.

Lindsey’s boss, Original Pancake House owner Eric Faulkner, can fill in the gaps of that day.

He says Lindsey’s cousin Charles picked him up from work. As they were driving away, Lindsey was laughing and joking, but suddenly slumped over and became unresponsive. Charles pulled into a shopping center parking lot and asked someone to call 9-1-1.

That’s where Shannon Walter enters the story.

A program manager at the Champaign Park District, Walter got some of her cardiopulmonary resuscitation (CPR) training at OSF. She was across the street getting lunch when she got an alert on her phone: someone close by needs CPR.

“When I pulled into the parking lot, I could see somebody pulling somebody who was unresponsive out of a vehicle and onto the ground,” Walter says.

That was Lindsey, who was in cardiac arrest, where the heart is not able to pump blood properly.

Walter quickly explained she was CPR-certified, observed Lindsey wasn’t breathing and did chest compressions for around three-and-a-half minutes until first responders arrived.

“I believe that is what saved his life and his brain function,” Faulkner says.

Lindsey agrees.

“She’s an angel,” he says. “It makes me feel really blessed. I’m glad she was there.”

Lindsey and Walter’s twist-of-fate encounter shows the importance of a couple life-saving things you can do in just a few minutes, says Kurt Bloomstrand, MD, medical director for East Central Illinois Emergency Medical Services, an OSF organization that trains first responders and CPR instructors.

One, learn CPR. It’s the missing link between when 9-1-1 is called and when first responders arrive. Dr. Bloomstrand says for cardiac arrest outside a hospital, the chance of survival is around 10%. With bystander CPR and use of an automated external defibrillator (AED), the chance increases fivefold.

Dr. Bloomstrand says good Samaritan laws exist to protect people who give first aid.

“You’re not going to hurt the person. You only have an opportunity to help them,” he says.

If you don’t have time for a CPR class, just remember this: push hard and fast on the center of the chest at 100 to 120 beats per minute. Appropriately, that’s the beat of Stayin’ Alive by the Bee Gees. Or if you prefer a more contemporary beat, think of the chorus of The Man by Taylor Swift.

“It’s important to never be caught in a situation where you don’t know what to do,” Walter says.

Two, download the PulsePoint app, the app Walter used to jump into action. PulsePoint is a nationwide app that OSF brought to the Champaign area. It’s active in nearly 5,000 other communities. Dr. Bloomstrand explains that when a 
9-1-1 call is made for cardiac arrest, the dispatcher sends the information to first responders. If PulsePoint is active in that area, the information – scrubbed of specifics to protect privacy – also automatically goes to the app. The app then sends an alert to PulsePoint users that CPR is needed and if an AED is nearby.

The fine print for the alerts: the emergency must be in a public place, and the bystander must be within one-fourth of a mile. And within the app, you must turn on CPR alerts and let the app track your location always, not just when you are using the app. That’s necessary to know anytime CPR is needed near you.

“This is how you, as a lay person, can be a hero, a lifesaver and help somebody in need,” Dr. Bloomstrand says.

Lindsey, meanwhile, is going through rehabilitation at OSF. He also got a pacemaker, a small device that creates electrical currents to keep the heart beating at a normal rhythm.

“I feel wonderful,” he says, adding that he hopes to be pouring coffee for customers again soon.

If you would like to learn in detail how to perform CPR or use an AED, there are several options, including visiting the American Heart Association website, or calling your local hospital to see what training is available. There are two versions of the PulsePoint app for download to your smartphone. PulsePoint Respond alerts you to cardiac arrest, and PulsePoint AED allows you to catalog AEDs around you.

Interview clips - Lester Lindsey

Interview clips - Eric Faulkner

Interview clips - Shannon Walter

Interview clips - Dr. Kurt Bloomstrand

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A survivor of a 2019 heart attack, Randy Isham was already on notice.

But Randy and his wife Dawn, retirees in Mansfield, Illinois, couldn’t predict the chaotic events of May 24, 2023. An ambulance took Randy to OSF HealthCare Heart of Mary Medical Center in nearby Urbana, and the man was soon fighting for his life due to a second heart attack.

“I’m glad to be alive,” Randy puts it plainly.

The Ishams and their OSF care team have now joined the chorus of heart health advocates, urging others to know when everyday exhaustion or dehydration is something more serious, especially if you have a history of heart issues.

From garage to gurney

On May 24, Randy was assembling a table in the garage when he began to feel weak but had no pain.

“When I touched his arm, it was a cold sweat,” Dawn recalls. “That’s when I got concerned that this didn’t seem right. Let’s call 9-1-1.”

It was in the ambulance that first responders determined Randy was having a heart attack. That’s when the flow of oxygen-rich blood to the heart is narrowed or blocked. Heart cells begin to suffer damage and die, and the heart no longer works how it should. Serious, life-long health issues or even death can result.

Randy coded at the hospital, adding to the urgency.

“It means there is no pulse. The heart stops. There is no blood reaching the brain and the whole body,” explains Tariq Enezate, MD, one of Randy’s OSF cardiologists. “When that happens, you need to know why and act fast.”

As the hospital pastoral care team and other Mission Partners (employees) kept Dawn informed, Randy was fighting for his life. He was without a pulse for 20 minutes, Dawn says, before Dr. Enezate’s team was able to revive him. Along the way, they removed a blood clot stemming from plaque buildup that they believe was the source of the heart attack. They then put in a stent. Randy is up to three stents, he points out, after his 2019 heart attack. It’s something he can speak about with relative ease now, but the nine-day hospital stay was no laughing matter.

“It could have gone either way,” Dawn says. “They wanted me to call the family in.”

Dr. Enezate describes the scene: “I had to go inside his heart while they were doing chest compressions. I was able to open [the blocked area in] his heart. At that moment, blood flow started back to the heart, and his pulse came back.

“Minutes mean muscle,” during heart attacks, Dr. Enezate adds. “The faster you restore flow in the artery and put a stent in, it’s better for the patient. It relieves their pain. It decreases the risk of complications.”

Lessons learned

Dr. Enezate calls Randy his miracle patient, and the Ishams agree.

“It was lucky he made it,” Dr. Enezate says. “I think the fact he came in early helped him.

“When we saw him coming back, that moment I can’t describe. It’s worth the world for all of us,” he adds.

Dr. Enezate’s affirmations “just gave me a nice warm feeling,” Randy says.

“Everybody there treated me like I was the only patient they had,” he adds, noting daily visits from Pastor Dave Jassman gave the couple strength.

Randy is back at home, doing well and receiving care typical for people who have suffered a major heart event, like therapy through OSF Home Care and cardiac rehabilitation. And he and Dawn are back at the healthy lifestyles that became the norm after Randy’s 2019 heart attack. Exercise is good, but no long work periods in the summer heat, for example. You’ll find Dawn cooking fish instead of steak. A tough, but necessary adjustment, Randy chuckles. Recipes from the American Heart Association also help.

“I used to think I was invincible, but I realize I’m not anymore,” Randy says.

The Ishams are also urging others to research trusted sources and learn not just the signs of a heart attack, but how to tell the difference between those signs and everyday pain like Randy thought he had on May 24. And don’t hesitate to call 9-1-1 when something is wrong.

“It could save your life,” Dawn says.

Dr. Enezate says the classic symptom of a heart attack is chest pain. Some people describe it as an elephant weighing on their chest. You may also be short of breath, sweat, feel anxious or feel like you’re going to pass out. Or you may have no warning signs, and suddenly you’ve collapsed.

“If you have symptoms and you’re not sure why, call [a health care provider] for advice,” Dr. Enezate advises.

What about prevention for people who’ve had a heart attack?

Practice healthy habits, Dr. Enezate says. Don’t smoke. Take medication as directed by your provider. Control risk factors like diabetes, blood pressure and cholesterol. Exercise and eat right.

Learn more

Read more about how to care for your heart on the OSF HealthCare website.

Interview clips - Dawn and Randy Isham

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Taylor Swift fans have another reason to celebrate: one of her songs could help save the life of someone in cardiac arrest.

The American Heart Association says Swift's song “The Man” has 110 beats per minute, in the 100-120 beats per minute range for effective cardiopulmonary resuscitation (CPR).

CPR is a life-saving skill. And for Jordan Meeks, a pediatric wellness specialist at OSF HealthCare, it’s a critical skill for young people to learn.

“Most cardiac arrests happen in people 40 years and older, a lot of teachers, parents, grandparents, coaches and those that young people are spending a lot of time with,” Meeks says. “And young people are getting to a point where their body is maturing, so they’re able to do those compressions with enough strength to be helpful.”

Meeks visits schools across Illinois teaching students hands-only CPR. Recently, she was in Fisher, a small, rural town where it might take first responders a little longer to get to an emergency - all the more reason to equip junior high and high school students with CPR skills.

CPR basics

Meeks says CPR is used when someone is unconscious and in cardiac arrest (in other words, having a serious heart problem).

The first thing to do is call 9-1-1. If you’re by yourself, put the phone on speaker while you help the ailing person. Get over the person, interlink your fingers and press hard in the middle of the chest over and over.

“It’s compressing the chest in half at a rate of about 100 beats per minute. Think of the song Stayin’ Alive by the Bee Gees,” Meeks explains. “The compressions help restore blood flow to the body and brain, which is really important to help preserve that person’s life.”

CPR may also be done alongside an automated external defibrillator (AED), a small device that’s common in schools and workplaces these days. Meeks explains that two pads are applied to the patient’s skin - one near the heart and the other on the person’s side - with wires leading to the AED box.

“It gives you step-by-step instructions. It’s going to tell you when you need to stay clear of the patient. It will analyze the heart’s rhythm to see if it’s regular, irregular or not beating at all,” Meeks says. “Then it will provide instructions on whether to deliver a shock. You press a button to deliver a shock. Then it will tell you to start CPR.”

The AED will then continue the cycle of shocks and CPR until first responders arrive.

Teaching hands-only CPR does not require certification, Meeks says. Someone can easily learn the tools and pass them on to others.

Adding the skillset of mouth-to-mouth resuscitation - when you exhale into a patient’s mouth to help revive them - is a little more involved. Meeks recommends calling your local first responders (police, fire and ambulance), your local hospital or the American Red Cross to learn about those CPR training opportunities.

 Training young people

During her stop in Fisher, Meeks watched as students performed CPR and applied AEDs to manikins. A red light on the manikin meant the compressions were too fast or too slow. A green light signaled a good pace. To Meeks’ delight, there were more green lights than red.

“The manikins are very much like the human body, so the students get a really good, hands-on experience with how CPR works,” Meeks says. “They also learn how to use the AED. Most students know where it is in their school, but they’ve never seen it before. They have no idea how it works.”

You can count Paige Ferguson and Kira Becker, both juniors at Fisher High School, among the adolescents who think the training is valuable.

“You just had to stay at a consistent pace, which was difficult [to start]. But once you got that pace going, it was pretty easy to stay with it,” Ferguson says, describing the training.

“It’s important to know this so you can help friends and teachers in your daily life. You can help save a person’s life,” Becker says.

One of those teachers is Doug Ingold, the health and physical education instructor who asked OSF to train the whole student body.

“It’s great to have hands-on experience. It’s different than just watching a video,” Ingold says. “Having OSF come in and give the students actual practical experience really gives them a good idea of what it takes to do CPR.”

Interview clips - Jordan Meeks

Interview clips - Paige Ferguson and Kira Becker

Interview clips - Doug Ingold

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Buffalo Bills player Damar Hamlin survived sudden cardiac arrest after he collapsed in the first quarter of Monday night’s Bills game against the host Cincinnati Bengals because of quick action by the medical team. CPR was initiated just minutes after Hamlin made a tackle, got up, but then collapsed.

On the field, Hamlin was also given oxygen, and an automated external defibrillator was used to save his life. The device analyzes a heart rhythm and will deliver an electrical shock if necessary.

Hamlin, who was sedated, awoke 48 hours later in a Cincinnati hospital and scribbled a note that read, “Did we win?” according to media reports. Sudhir Mungee, MD, an interventional cardiologist with OSF HealthCare Cardiovascular Institute in Peoria, Illinois says those immediate measures on the field allowed Hamlin to survive the sudden cardiac arrest.

“So, two things that as a common citizen we all can learn is effective CPR and number two, to know how to use an automatic external defibrillator (AED). At most of the common places whether schools, colleges, business places, we have the presence of an AED. I think it is important to know how to use an AED because the earlier you can restore the rhythm from ventricular fibrillation to sinus rhythm, regular rhythm, the higher the chances of recovery.”

There is a free smartphone app called Pulse Point that acts as a community registry to identify where AEDs are located and specifics to identify where they can be found in case of emergency. The American Heart Association regularly offers CPR and AED training.

Hamlin remains in critical condition, and the cause of his cardiac arrest remains unknown. Still, his doctors say his recovery is remarkable and that his communication indicates he could be “neurologically intact.” Dr. Mungee points out, heart attacks from blocked arteries commonly cause out-of-hospital cardiac arrest, but in absence of heart attack, structural heart disease such as cardiomyopathy are among common causes of cardiac arrest.

In athletes, “hypertrophic cardiomyopathy. (That’s having a) very thick heart muscle, which is more prone to electrical disturbance, especially during strenuous activities.”

Dr. Mungee says cardiomyopathy could be inherited or brought on by a recent infection. There are other structural heart abnormalities that might not have been detected by the NFL’s physical. The football league’s exam does include an electrocardiogram (EKG) which records the electrical signal from the heart to check for different conditions.

If other causes are ruled out, Dr. Mungee thinks, although rare, something called commotio cordis (kuh-MOH-dee-oh KOR-dis) could be responsible for Hamlin’s cardiac arrest. This happens when blunt force hits an area of the heart at precisely the vulnerable moment between heartbeats.

“So about 10 to 30 milliseconds – if the impact happens during that risk window in that segment of the heart, with impactful energy,  it can certainly lead to irregular heart rhythm, which is called ventricular fibrillation, Dr. Mungee explains. “Now, many times, it can spontaneously resolve, but if it doesn't, ventricular fibrillation will lead to sudden cardiac arrest and collapse.”

Younger individuals are more susceptible to comotio cordis because, as Dr. Mungee points out, their chest wall is typically thinner.

What happened to Hamlin stunned fellow players and everyone watching the Monday Night football game. It also, no doubt, has raised concerns for parents of children who play high-contact sports. Dr. Mungee says this incident highlights the important role coaches play in protecting athletes.

“There is a tremendous role of your sports coach. For example, the coaches train our kids and athletes to know how to dodge the ball. If there is a pitch, how to avoid impact on the front of the chest, how to appropriately wear protective gear. That’s very important.”

As for his recovery, Dr. Mungee says it could take weeks or months for Hamlin to be restored to good health. How long will depend on damage to Hamlin’s vital organs, including the brain. He says neurological recovery leads the path for recovery of the rest of the body because it impacts all cognitive and motor functions.

Video Clips with Dr. Sudhir Mungee, interventional cardiologist, OSF HealthCare Cardiovascular Institute