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Okay so a few times already since the incident with Demar Hamlin in the NFL, I've been asked about or had conversations with friends and colleagues about hands only CPR.
That night, Damar suffered what is known as commotio cordis, a sudden cardiac
arrest due to impact to the chest. If an impact is great enough and occurs at a specific time in the heart cycle, it can disrupt the heart's normal electrical activity, resulting in ventricular fibrillation. It is rare, but when happens, the chances of survival are significantly increased if CPR is administered and an AED (automatic external defibrillator) is used as soon as possible.
The athletic trainers, paramedics, and doctors involved in responding to Demar Hamlin used hands only, or compression only, CPR. This means that they did not give rescue breaths, but rather only performed continuous compressions until the AED was placed on and a shock administered.
But, its Cardio-PULMONARY resuscitation, why did they leave out the pulmonary part?
There are two scenarios for hands only CPR:
If you are an untrained, unwilling or unable to give full CPR and witness an adult or teen suddenly collapse and become unresponsive. Often, bystanders feel unsure of what to do in such a situation or are afraid of hurting the collapsed individual, but remember, doing something is better than doing nothing. As there is likely still sufficient oxygen in the blood to allow for adequate perfusion (i.e. transfer of oxygen to tissues), hands only CPR can still improve outcomes for an individual even without rescue breaths. Not having to do rescue breaths can increase the likelihood of a bystander taking action as it less invasive and less risky for transmission of disease.
First responders will use hands only CPR when there is a sudden cardiac arrest e.g. due to commotio cordis, or heart disease.
Rescue breaths are still important
Rescue breaths are still recommended when there is any suspected respiratory distress and for children and infants. This includes when responding to drowning victims, overdose victims, or collapse due to asthma or other lung diseases.
Remember, before administering CPR, first call 911, and make sure it is safe to approach the collapsed individual. Do not approach if it is unsafe. When we are giving CPR, it is 30 compressions then 2 rescue breaths. Give compressions at a rate of 100 per minute, or to the beat of a song like Baby Shark or Statin Alive. If giving hands only CPR, give compressions at the same rate of 100 per minute.
For more information bout CPR and CPR training, you can go to the Red Cross' webpage, or the Heart & Stroke Foundation.
This incident highlights the importance of having athletic therapists (or athletic trainers in the states) on the sidelines at sporting events. Though it is rare, instances such as these require immediate and specific action for there to be positive outcome. Read here about what an athletic therapist does and how they can benefit you.
If you have any questions about finding an athletic therapist near you for your next event, contact me here.
References:
Tainter, C. R., & Hughes, P. G. (2022). Commotio Cordis. In StatPearls. StatPearls Publishing.