Damar Hamlin’s Cardiac Arrest Shows Importance of Preparation for Cardiac Emergency in Sports, Schools
The Project ADAM program at Cook Children's trains school staff members on CPR, how to use an automated external defibrillator (AED), and helps the school create an emergency plan.
By Eline Wiggins
Buffalo Bills defensive back Damar Hamlin suffered cardiac arrest after a hit during Monday evening’s game. The Bills said in a statement that he was given CPR on the field and his heartbeat was restored. On Tuesday, the Bills said Hamlin was in critical condition.
This incident stunned the sports world and community at large, and reiterates the importance of being prepared for a cardiac emergency, especially in sports and school settings, with CPR and an AED. 
More than 530 schools in North Texas have partnered with Project ADAM at Cook Children’s to become a “Heart Safe” school. The program trains school staff members on CPR, how to use an automated external defibrillator (AED), and helps create an emergency plan. It also provides resources and support to become a Heart Safe school, which is renewed every year through training and requirements. Project ADAM is a free resource to schools and the community.
The likelihood of sudden cardiac arrest in children and young athletes is known to be enhanced by athletic participation. On average, a seemingly healthy young person suffers a sudden cardiac arrest every three days in the U.S. and it's the leading cause of death in exercising young athletes.
Athletic personnel need to recognize the threat to young athletes and properly prepare for sudden cardiac arrest. Every school or organization that sponsors athletic activities should have an AED, trained coaches, and written Emergency Action Plan.
Cardiac emergency preparedness training empowers people to use the AED device. Texas requires all schools to have an AED, but often people don’t know where it is located, how to use it in an emergency or rely solely on the school nurse to use the device.
Danielle Moyé, M.D., pediatric cardiologist and physician director for Project ADAM at Cook Children’s, encourages schools, parents and the community to see the large impact an AED and CPR can make on a person’s life if utilized effectively. She shared answers for a few common questions.
What causes cardiac arrest?
Cardiac arrest can be caused by different factors. In an exercise setting, cardiac arrest occurs secondary to an arrhythmia which prevents adequate circulation and perfusion of blood and oxygen to the brain and body.
Why is it important to quickly respond to cardiac arrest? How does it affect the person’s outcome?
Timing is of utmost importance when it comes to cardiac arrest. The rhythm that one is in during cardiac arrest is not a perfusing (pump) rhythm. This means that there is not adequate oxygen and blood flow to the brain and body. Restoring sinus rhythm is critical to prevent irreversible organ damage.
When do you use an AED vs administering CPR?
CPR should be administered as soon as a person is found down without a pulse. While awaiting an AED, appropriate CPR can result in continued blood flow and perfusion that the heart is not doing on its own.
Once an AED is available, pads should be placed on an individual’s chest and once turned on, CPR may be paused briefly while the AED is assessing the underlying rhythm. If the person has a shockable rhythm, the AED will recommend delivery of a shock which can restore sinus rhythm. This is a lifesaving device that the world should know about and everyone should familiarize themselves with. 
What should parents and caregivers be aware of if their child participates in sports and other physical extracurricular activities?
As mentioned above, parents and caregivers need to be aware of sudden cardiac arrest. They should encourage the schools and sporting facilities to be aware of the risk, have respect for this risk, and arm themselves with knowledge on good CPR, the locations of AEDs, and have an emergency action plan in place should one need it.
What do you see as a cardiologist that you wish more people knew about?
I unfortunately, have seen many episodes of cardiac arrest associated with exertion and at rest. The patients that have the best outcome are those who had a prompt intervention with an AED. I wish every school and every facility had an AED in place and a team dedicated to responding to these types of emergencies.
Sign and symptoms of pediatric heart disease
Sudden cardiac arrest (SCA) is when the heart suddenly and unexpectedly stops beating. SCA often occurs in active people with no history of heart conditions. In children, common causes are genetic, congenital or related to a sudden blow to the chest. If treated quickly, using an automated external defibrillator (AED), it is possible to restart the heart and increase the chances of survival.
Pediatric heart disease has warning signs and symptoms that can go unnoticed. It is important to recognize the following:
- Fainting or near-fainting during or after exercise, emotion or surprise
- Dizziness or lightheadedness
- Extreme fatigue associated with exercise
- Extreme shortness of breath associated with exercise
- Discomfort, pain or pressure in chest during or after exercise
- Skipping or racing heartbeats
- High blood pressure
- Congenital heart abnormality
- Family history of sudden death prior to age 50 or known heart abnormalities
Not all episodes of sudden cardiac arrest are preventable because many of the kids do not have symptoms until they have the episode. For this reason, secondary prevention strategies are important.
About Project ADAM
Project ADAM, which is nonprofit and nationwide, aims to educate school systems, nurses, coaches, trainers, parents and others about pediatric sudden cardiac death and to establish emergency programs to help provide a timely and lifesaving response as emergency medical services are on their way to an incident.
Project ADAM was started in 1999 after a 17-year-old Wisconsin student named Adam Lemel collapsed and died while playing basketball. His parents helped start the Project ADAM program at the Children’s Hospital of Wisconsin in his memory. Cook Children’s is one of 35 hospitals and program sites providing free cardiac resources, including training and AED devices.
RELATED: How to Become a Heart Safe School
Videos:
Project ADAM program at Cook Children's
The primary goal of Project ADAM Texas is to provide schools across Texas with the necessary tools and education to plan, fund and develop their public access defibrillation (PAD) program.
To schedule your free school consultation and receive the steps and resources necessary to make your school a designated Project ADAM Texas Heart Safe School, contact Sarah Thieroff, Project ADAM Texas Program Coordinator, 682-885-6755 or through email at ProjectAdamTexas@cookchildrens.org.
