Saving Lives

The January 2 game between the NFL’s Cincinnati Bengals and Buffalo Bills will unfortunately be remembered as the one during which Bills’ safety Damar Hamlin, 24, experienced sudden cardiac arrest on the field and collapsed after tackling Cincinnati’s Tee Higgins in the first quarter. 

Medical personnel immediately performed cardio-pulmonary resuscitation (CPR) on Hamlin and successfully revived him before he was taken by ambulance to a local hospital. He continued his recovery for the remainder of the season.

However, if the incident underscored anything, it is how adept medical personnel including athletic trainers, team doctors and Emergency Medical Technicians (EMTs) at stadiums and arenas are at handling such life-or-death situations. 

“As a trainer, its worst-case scenario, the one thing you never want to have to deal with or have happen to one of your athletes,” said Jesse Ramirez, head athletic trainer for the FC Dallas Major League Soccer (MLS) team, which plays its home games at Toyota Stadium in Frisco. 

 Ashley Rudolph is athletic trainer for the Frisco-based Texas Legends, the G-League affiliate of the National Basketball Association’s Dallas Mavericks. 

“For me to see a player drop like that, it’s probably one of the scariest moments as an athletic trainer,” Rudolph said. “It’s one of those emergency situations you prepare for, but hope you never see.”

Similar emergency incidents have previously occurred involving North Texas-area professional and amateur athletes. 

 In March 2014, Rich Peverley of the National Hockey League’s Dallas Stars experienced what was described as a “cardiac event” on the bench during a game. Fortunately, quick thinking by the team’s medical staff, including the team doctor, saved Peverley’s life. 

In November 2022, Kamathi Long, a 16-year-old junior varsity basketball player at Crowley High School near Fort Worth, collapsed during a game. After his mother raced across the court to begin CPR, Crowley’s trainer successfully revived him despite the fact that he had been unconscious for two minutes due to sudden cardiac arrest. 

Every two years, athletic trainers are required to recertify their CPR training, but Ramirez and his staff at FC Dallas also train quarterly on Resuscitative Quality Instruction (RQI), during which trainers utilize so-called “smart” simulator dummies to ensure the chest compressions they perform are deep enough to be effective. 

 “I’ve never had to do CPR on a live person but guarantee that if I have to, I know what it’s going to feel like because those dummies are pretty realistic,” Ramirez said. 

Rudolph doesn’t only maintain her CPR certification, but she’s also an instructor certified by the American Red Cross and teaches Mavericks staff members who need to recertify their life-saving training. 

“I can teach first aid, CPR/AED (automatic external defibrillator), and then I can teach BLS (basic life support),” Rudolph said. “BLS is for the athletic trainers. We need something that’s a bit more advanced than the basic CPR/AED (course).”

 One of the most important pieces of equipment each sports team has is an AED, a device that can deliver an instant electrical shock to the heart of someone experiencing sudden cardiac arrest. In most cases, this jolt can restart a person’s heart. 

Sports teams typically have AEDs near the playing field or court should a player or team staffer suffer a cardiac event. These life-saving devices often are also stationed throughout sports venues.

“We’re always trying to make sure our AED is good to go and it’s nearby. For games, we have it under our seat right on the bench,” Ramirez said. “For training, we have it on our cart and that cart is in the exact same spot every day, so everyone knows where the AED is in case there’s any kind of a cardiac situation that unfolds.”

Another constant across every sport is the presence of an emergency action plan (EAP), a document that is updated prior to the start of each season and details how on-court or on-field emergencies are to be handled from start to finish. 

 “We have our EAP posted. It’s in the training room, it’s online, it’s shared to the entire league,” Ramirez said. “When teams come (to play against FC Dallas), there’s a link where they can see our gameday EAP.  We’ve made sure that it is always current. We always review it internally with the athletic trainers on staff (and) with our team doctors that are on the sidelines.”

Several years ago, MLS began placing a venue medical doctor (VMD) at its matches. The neutral physician is at the stadium to assist with any head injuries or cardiac events during matches. 

Another crucial aspect of being prepared for on-court or on-field emergencies is the presence of EMTs from local fire departments. Along with an ambulance, these personnel are on standby near the field or court. Should a need for their assistance arise, team medical personnel inform the EMTs through a signal of a siren overhead (during soccer matches) or with a closed fist (during basketball games). 

 “The relationship that we have with EMTs is also extremely important. We meet with them prior to the start of the season to talk and run through the emergency action plan,” Rudolph said. “My goal at every game the Texas Legends host is to introduce myself … to meet with the EMTs. Having that relationship with Frisco Fire has made my job extremely easy and made me feel at ease.”

Since Hamlin’s on-field incident earlier this year, high praise has been heaped on those who responded to that on-field emergency in Buffalo. The trainers, team doctors and EMTs who assisted him have earned kudos for showing how well-trained and proficient they are in keeping athletes safe.

Ramirez said it was “a proud moment to see how well they handled the whole situation.” 

 Rudolph described it as a stellar showing by her colleagues in the direst of situations — one which trainers and other medical personnel hope they will never have to face.  

“It was a phenomenal job by the medical staff,” she said. “I’ve talked to other athletic trainers that I’m still pretty close with — my mentors and other individuals that I went to school with — we (agree) it was a phenomenal job.”