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At every NFL game, there are at least 29 medical personnel on the field, among them primary care physicians, orthopedists, chiropractors, neurotrauma consultants, dentists, emergency medical technicians, an airway management physician and ophthalmologists, among others.
Even with all these specialists, it was Denny Kellington, an assistant trainer with the Bills, that was the first to get to Hamlin. He made a quick assessment and immediately began cardio pulmonary resuscitation (CPR) until Hamlin was stable enough to be transferred to a waiting ambulance.
"The reasons we're talking about Hamlin's neurological function is due to his immediate access to good CPR and defibrillation," Dr. Timothy Pritt, one of Hamlin's doctors at the Cincinnati Medical Center, said. "The Bills' staff did really outstanding work."
Watching the dramatic events with great interest were high school trainers from Lamorinda and Saint Mary's College. "When you see a situation like that, as a trainer, I consider what I would do, running through that scenario and talking it through," said Josh Shaw, St. Mary's Head Trainer.
Miramonte's Head Trainer John Grigsby was also watching the game with a critical eye. "I was in the mix watching the play and felt very involved and critical with what was going on in this and in all other situations," Grigsby. "It's always good to see how other people respond and see what they did right and what they did wrong."
Acalanes Head Trainer Chris Clark was trying to interpret what he was seeing on television. "My first reaction was that it wasn't head-related. Since I hadn't seen what type of impact Hamlin received, when I saw how they were working on him, I immediately thought about the possibility of commotio cordis (an injury that occurs when you're hit in the chest?and that impact triggers a dramatic change in the rhythm of the heart), though I didn't think the hit was significant enough to send it into that."
As Hamlin recovers, Kellington's trainer colleagues emphasize the importance of his quick response after the hit. "I hope this event highlights the importance of the work that we do as athletic trainers and promotes us as professional health care providers for high schools, colleges, club teams and professional teams," Shaw said. "We are health care providers, and that's what we're trained to do - take care of every situation that could arise. Many people have misconceptions about our roles and responsibilities. When they hear the word `trainer' they think we tell people how to lift weights and how to do everything but what we do. I was glad to see how Kellington was prepared to do his job, and he had a great outcome."
There is a big difference between a certified athletic trainer and a personal trainer or fitness instructor that it is not surprising that the average person may not understand the distinction, as the word trainer is often used loosely to describe many people who work with athletes. "Athletic trainers are actually allied health care professionals like physical therapists, emergency medical technicians, paramedics and nurses, though there are still some people that think we just hand out towels and tape up a couple of players," Clark said. "I have talked with some health care professionals about what occurred in Buffalo, and they concluded that there aren't too many other places other than an NFL game where he might have survived. Given the set of circumstances with all of the trained personnel on hand, he absolutely got what he needed with everybody doing their job the right way."
For Miramonte's John Grigsby, it's not attention that trainers are looking for, it's the end result. "The recognition Kellington is getting is amazing, but I think most athletic trainers would agree to be satisfied with being the guy behind the guy, the team behind the team," Grigsby said. "We want the superstars to remain in the spotlight and if it's in our ability to keep them safely out there, that is recognition enough. It's tremendous that people are recognizing athletic trainers and why it's so important to have them at these events."
A trainers' job is not restricted to the athletic field. Shaw is on call at all times on the Saint Mary's campus as are high school trainers. "When you do this job, you see a lot of different things and your goal is always to have a good outcome," Shaw said. "I was called to help with an office worker who they said had sprained his ankle. As he kept slurring his words, I realized that he was suffering from a stroke and immediately called for an ambulance. When you work in the healthcare field, you learn to identify those things. At the very least, you want to give them their best chance for survival."
Clark and Grigsby use incidents such as Hamlin's injury as teaching tools. "This was a really valuable learning experience for my class," Clark said. "We see numerous injuries that required on-field care, ranging from concussions to broken bones and now with Hamlin's heart stoppage. What we all saw was a reminder of how important an athletic trainer is and why we train our students in first aid, CPR and the use of the Automated External Defibrillators (AEDs) so I have that extra set of valuable hands with me if necessary."
Each week, Grigsby's students describe various plays they've seen where an injury has occurred. "It's a perfect learning moment for them," Grigsby said. "On TV and YouTube, we're able to rewind and watch these events unfold, determining what we would have done, constantly rehearsing and practicing every situation. We've had cases of in and out of consciousness and a potential spinal cord injury. It can be scary in the moment, and that is why we constantly practice all of our emergency response systems."
AEDs are now standard equipment in most high schools and colleges. "At Saint Mary's we have AEDs in every facility and at all of our athletic venues," Shaw said. "We're all trained in cardiac issues but that is just part of the job, in that we're ready to handle any situation by constantly rehearsing our emergency action plans for whatever situation might arise whether it's during practice, in a game or on campus."
The same basic training equipment requirements also apply to the high schools. "When I first arrived at Miramonte 18 years ago, we only had three AEDs on campus," Grigsby said. "Now, every school in the Acalanes Union High School District has at least six AED's on site. The more people that have the skill and the wherewithal to step in and be a good Samaritan is really necessary, and the more people that have the skill and experience the safer the rest of us are. Knock on wood, we haven't been called upon to use an AED yet."
At Acalanes, AEDs are located strategically across the campus. "We are ready to help anyone, whether it needs to be used on an athlete, a performer or somebody in the crowd," Clark said. "What happened in the Buffalo game was what was needed to be done was practiced many times, from the medical personnel to the ambulance services on standby. In this case, everything clicked, and all the training and practice they did leading up to that moment paid off because everybody did their job and saved his life."
All of the trainers interviewed agree that, at minimum, everyone, not just trainers, should learn the basics of Cardio Pulmonary Resuscitation (CPR) and basic first aid skills along with being able to recognize the signs of distress. "If there is a lesson to be learned by what happened to Hamlin, it's how important it is for everyone to learn CPR, learning the signs of a stroke, how to help someone who's choking, and how to make the correct 911 call by providing the correct information to let the paramedics know what they need to bring to the scene," Shaw said. "The more someone knows, the less of a shock it will be to suddenly come upon a life and death situation. It's not always a great outcome but at least you can know that you did everything that you could, and if you gave somebody a chance to live at the end of the day, that's the greatest thing."
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Lamorinda Weekly, Moraga CA