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The planet is getting hotter fast. This is what happens to your body in extreme heat | CNN

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CNN
 — 

The Earth recently recorded its hottest day ever – a record experts warn will likely be repeatedly broken as the climate crisis drives temperatures higher and higher.

And it’s happening fast: a new report found last month was the planet’s hottest June by a “substantial margin,” meaning the nine hottest Junes have all occurred in the last nine years.

Extremely hot days – what could be considered the hottest days of the summer – are more frequent now than in 1970 in 195 locations across the US, according to the research group Climate Central. Of those locations, roughly 71% now face at least seven additional extremely hot days each year.

The effects have been devastating.

In one Texas county, at least 11 people died in just over a week during an unrelenting June heat wave. In Mexico, soaring temperatures have killed at least 112 people since March. A recent heat wave in India killed at least 44 people across the state of Bihar.

Here’s what happens to your body in extreme heat, what you need to watch out for and how to stay safe.

Normally, your body is used to a certain range of temperatures, usually between 97 to 99 degrees Fahrenheit. When your brain senses a change – either lower or higher than that – it attempts to help your body cool down or heat up, according to Dr. Judith Linden, executive vice chair of the department of emergency medicine at Boston Medical Center and a professor in the emergency medicine department at Boston University’s school of medicine.

“There are a number of different ways in which (the brain) attempts to cool the body down. One way, the most common way we think of, is that you sweat,” Linden said. “The pores open, the body sweats and the sweat evaporates, that cools the body.”

The second way your body cools itself down is by dilating vessels and upping your heart rate, which helps bring heat and blood to the surface of your body and helps releases that excess heat.

When you’re exposed to high temperatures, it becomes harder for your body to try and keep up with cooling itself down. And if your environment is hot and humid, sweat doesn’t evaporate as easily – which pushes your body’s temperature even higher, according to the Mayo Clinic.

“The higher the humidity, the lower temperatures you need for extreme heat,” Linden said.

High body temperatures can lead to damage to the brain and other vital organs, the CDC says. They can also lead to several heat-related illnesses.

Mild-heat related illnesses, including heat cramps, are most common, Linden said. Heat cramps can develop in people who sweat a lot, including during exercising. The excessive sweating uses up all of the body’s salt and moisture and can lead to muscle pains or spasms, usually in the abdomen, arms or legs, according to the CDC.

A heat rash can also develop. That’s a skin irritation caused by too much sweating in hot and humid weather, and is most common in young children, the CDC says. It is usually a red cluster of pimples or blisters, and tends to be in places including the neck, upper chest or in elbow creases.

When your body’s beginning to exceed its ability to cool itself down, you can develop what’s known as heat exhaustion.

“In this case you’re going to see excessive sweating because your body is really going to try and keep up with that extra heat. You’re going to feel light-headed, you may feel dizzy, often people present with nausea, headaches and their skin often looks pale and clammy and their pulse is often fast,” Linden said.

“This is the body’s last attempt to cool itself before it really goes into a point of no return.”

A heat stroke is the most serious heat-related illness, and, if left untreated, can lead to death.

“That’s where your body’s temperature goes above 104 to 105 degrees or so, and this is where your mechanisms are starting to fail,” Linden said.

Warning signs may include extremely high body temperatures, red and dry skin, a rapid pulse, headache, dizziness, nausea or loss of consciousness, according to the CDC.

The hallmark of a heat stroke is confusion and agitation, Linden said.

“So when somebody’s in the heat and they become confused and agitated, that’s heat stroke until proven otherwise and you need to call 911 for that or get help immediately and get the person out of the heat.”

Elderly, people with chronic medical conditions as well as children are at higher risk for severe heat-related illnesses.

The elderly and people with chronic medical conditions may be less likely to sense and respond to temperature changes and may be taking medication that make the heat effects worse, the CDC said.

“Very young (people) as well, because they’re less likely to recognize heat-related illness and they’re less likely to get out of the heat if they’re starting to feel overheated,” Linden said.

Student-athletes and pets are also at higher risk, she added.

“In this weather, you must never, ever, ever leave a child or a pet in the car for even a minute,” Linden added.

When your community is facing extreme heat, there are several things you can do to keep yourself and others safe.

First, keep an eye out for symptoms of heat exhaustion or other illnesses.

“If somebody starts feeling light-headed, dizzy, nausea or headache, that is the time to act immediately,” Linden said. “That means getting them out of the heat and into a cool environment.”

Putting water on someone who may be experiencing symptoms and giving them fluids can help cool them down. If someone is starting to lose consciousness or has nausea or vomiting, call 911.

“If you see anybody with any type of confusion, that’s an immediate red flag,” Linden added.

When it’s hot outside, try to avoid outdoor activities – especially between the hours of 11 a.m. and 3 p.m., according to Linden. If you have to go outside, wear light-colored clothing, cover your head and drink plenty of fluids.

Don’t wait until you’re thirsty to drink water – as that can be a sign of dehydration. Linden recommends drinking at least one glass of water – or more – an hour.

“If you do start to feel light-headed, dizzy, sweating, fast pulse, get out of the heat immediately,” Linden said.

Try to find air conditioning, or places in your area where you can go to stay cool, according to Ready.gov. Even spending a few hours in a shopping mall or public library can help.

When you’re home, fans can help, but don’t rely on them as your only way of cooling down – while it may feel more comfortable, they won’t help prevent heat-related illness.

“If you’re in a super hot room, if you’ve got a fan, is it helpful? No. I think, if you’ve got a fan, and you’re able to mist yourself … then fans can be helpful,” Linden said. “Fans are not foolproof.”

Finally, make sure you’re checking on your neighbors, parents and friends – especially older individuals who may be living alone or are isolated, Linden said.

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In extreme heat, here are 14 ways to keep your body and home cool without AC | CNN

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Editor’s Note: This story was first published in 2020 and has been updated.



CNN
 — 

Whether you’re without power, enduring extreme heat or trying to save money, there are ways to feel comfortable without artificial cooling.

Heat can foster fun summer activities, but the body shouldn’t be too hot for too long, as too much heat can harm your brain and other organs, according to the US National Institutes of Health. Sweating is the body’s natural cooling system, but when that’s not enough, there’s increased risk for developing the heat-related illness hyperthermia — signs of which include heat cramps, heat edema and heat stroke. Heat combined with high humidity exacerbates this risk, since the air’s saturation level makes sweat accumulate on the skin, preventing the body from cooling naturally.

Staying cool can be done by using some basic supplies and knowing how to manipulate your home to control its temperatures. Here are 14 methods for doing so.

When you’re hot and flushed, hydrating yourself is the first and foremost step to cooling down, said Wendell Porter, a senior lecturer emeritus in agricultural and biological engineering at the University of Florida.

The temperature of the water doesn’t matter since your body will heat it, he added. If your body is suffering from the heat and needs to cool itself, it can’t do that without enough moisture, since the body cools itself by sweating.

Taking a cold shower or bath helps cool your body by lowering your core temperature, Porter said.

03 cool down wellness

For an extra cool blast, try peppermint soap. The menthol in peppermint oil activates brain receptors that tell your body something you’re eating or feeling is cold.

02 cool down wellness

Place a cold washrag or ice bags (packs) on your wrists or drape it around your neck to cool your body. These pulse points are areas where blood vessels are close to the skin, so you’ll cool down more quickly.

Place box fans facing out of the windows of rooms you’re spending time in to blow out hot air and replace it with cold air inside.

09 cool down wellness

If the weather in your area tends to fall between 50 and 70 degrees Fahrenheit in the mornings and evenings, opening the windows on both sides of the house during those times can facilitate a cross-flow ventilation system. If you do this, you can opt to use or not use the fans, but the fans would help cool the house faster, Porter said. The outdoors can pull the hot air from your home, leaving a cooler temperature or bringing in the breeze. Just be sure to close windows as the sun comes out, then open them when the weather is cool again.

Just resting near a fan would reduce your body temperature as well.

If you have windows that face the sun’s direction in the morning through afternoon, close the curtains or blinds over them to “keep the sun from coming directly into the house and heating up (the) inside,” Porter said.

05 cool down wellness

You could also install blackout curtains to insulate the room and reduce temperature increases that would happen during the day.

If you do turn the air conditioning on, don’t set it below 70 degrees Fahrenheit in an effort to cool the house faster, said Samantha Hall, managing director of Spaces Alive, an Australia-based design research company helping to create healthy, sustainable buildings.

“It just runs for longer to reach that temp and will keep going until you start to feel a bit chilly and is then hard to balance,” she added. Instead, keep the unit temperature as high as possible while still comfortable.

Cotton is one of the most breathable materials, so cotton sheets or blankets could help keep you cool through the night.

04 cool down wellness

The lower the thread count of the cotton, the more breathable it is, Porter said. That’s because higher thread counts have more weaving per square inch.

If you can’t sleep through the night because you’re too hot, try sleeping somewhere besides your bedroom, if that’s an option. Heat rises, so if you have a lower or basement level in your home, set up a temporary sleeping area there to experience cooler temperatures at night.

Common advice for staying cool without air conditioning includes refrigerating or freezing wet socks, blankets or clothing then ringing them out to wear while you sleep. But this isn’t a good idea, Porter said.

Because of “the amount of energy they can absorb from your body that night, they will be warm in just a matter of minutes,” he said. “And then you’d have damp stuff that would mold your mattress. So you definitely don’t want to do that.”

If no one’s using a room that doesn’t have vents or registers, close the door to that area to keep the cool air confined to only occupied areas of the house.

Flip the switch for the exhaust fan in your kitchen to pull hot air that rises after you cook or in your bathroom to draw out steam after you shower.

Incandescent light bulbs generate a higher temperature than LED light bulbs do. To make the switch, watch for sales on energy-efficient bulbs, then slowly replace the bulbs in your house, Porter said.

08 cool down wellness

Switching light bulbs can save money but won’t reduce a lot of heat in the home, Hall said. However, if you focus on switching the bulbs in areas you’re sitting near, that would make a more noticeable difference, Porter said.

01 cool down wellness

Oven heat can spread throughout your house. Keep the heat centralized in one area, such as a slow cooker. Or, cook outdoors on a grill to keep the heat outside.

Eating an ice pop or ice cream to cool down may help for a moment. But don’t go overboard on the sugar if you’re overheated or at risk of being overheated, Porter said.

06 cool down wellness

“Sugar would run your metabolism up and you’d start feeling internally hot,” he said. “So the cool treat might be good, but the extra sugar might not.”

If you’ve tried everything and still can’t beat the heat at home, you could look online for any local programs that are offering ductless air conditioners.

Depending on your state, some cooling centers — air-conditioned public facilities where people might go for relief during extremely hot weather — may be open and taking precautions to ensure they’re as safe as possible. You could start by checking with your local utility offices, as they would know who is offering certain programs, Porter recommended.

READ MORE: Get inspired by a weekly roundup on living well, made simple. Sign up for CNN’s Life, But Better newsletter for information and tools designed to improve your well-being.

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Pediatricians are giving out free gun locks to approach the gun violence epidemic as a public health crisis | CNN

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CNN
 — 

In a triage waiting room of St. Louis Children’s Hospital in Missouri, a clear basket filled with gun locks sits near the walkway, just noticeable enough to those passing by.

The hospital staff calls it the “No Questions Asked” basket, to encourage gun safety without having to confront gun owners about what can be a sensitive and divisive topic. It holds an assortment of cable gun locks free of charge, available to those who need them, alongside pamphlets explaining how to properly and safely store firearms.

The initiative, aimed at reducing the stigma of addressing gun safety, is part of a growing effort by medical professionals who are treating the country’s gun violence epidemic as a public health crisis.

“It takes standing at the bedside of one child who has been shot to realize that we all have to do more and as the leading cause of death for children in this country, pediatricians need to be front and center of the solution, of all the solutions,” said Dr. Annie Andrews, a professor of pediatrics at the Medical University of South Carolina and an expert on gun violence prevention.

Over the course of two years, thousands of gun locks have been taken from the basket, according to Dr. Lindsay Clukies, a pediatric emergency medicine physician at the hospital.

In the coming weeks, baskets filled with free gun locks will be available at more than 17 locations operated by BJC HealthCare, an organization serving metro St. Louis, mid-Missouri and Southern Illinois, Clukies said. It’s a low-cost and effective way to easily distribute firearm safety devices.

“We’ve had employees as well as patients take our locks, also their families and even a grandmother who took one for her grandson. It’s for anyone who needs them,” Clukies told CNN. In recent years, a rising number of pediatricians across the country have been engaging with the topic of gun safety in medical settings by focusing on safety and prevention, already a natural aspect of their work.

During patient visits, it’s increasingly common for pediatricians to ask the patient’s parents if there are guns at home, and if so, how they are stored. Some hospitals then offer free gun locks, often sourced from donations or police departments and paired with safe storage education.

Some pediatricians, who bear witness to the effects of gun violence on children in their workplace every day, told CNN they see it as their obligation as medical professionals to be part of the solution to the epidemic.

In 2022, 1,672 children and teenagers under 17 were killed by gun violence and 4,476 were injured, according to the Gun Violence Archive, a nonprofit organization tracking injuries and deaths by gunfire since 2014.

“We have just as an important voice in this conversation as anyone else because we’re the ones who have invested our entire careers to protecting children and ensuring that children can grow up to be the safest healthiest version of themselves,” said Andrews.

“It is only natural that we see these things that we understand that they’re preventable, and we want to get involved in finding the solutions,” she added.

So far in 2023, high-profile incidents of children accessing firearms have heeded calls for stronger, more consistent laws nationwide, requiring adults to safely secure their guns out of the reach of children and others unauthorized to use them. They have also highlighted a lack of public education on the responsibility of gun owners to store their guns unloaded, locked and away from ammunition, CNN previously reported.

In early January, a 6-year-old boy was taken into police custody after he took a gun purchased by his mother from his home, brought it to school and shot his teacher at Richneck Elementary School in Newport News, Virginia, police said. Just over a week later, a man was arrested in Beech Grove, Indiana, after video was shown on live TV of a toddler, reportedly the man’s son, waving and pulling the trigger of a handgun, CNN previously reported.

Hundreds of children in the US every year gain access to firearms and unintentionally shoot themselves or someone else, according to research by Everytown for Gun Safety, a leading non-profit organization focusing on gun violence prevention. In 2022, there were 301 unintentional shootings by children, resulting in 133 deaths and 180 injuries nationally, Everytown data showed.

Firearm injuries are now the leading cause of death among people younger than 24 in the United States, according to the Centers for Disease Control and Prevention. The American Academy of Pediatrics released an updated policy statement in October 2022, stating firearms are now the leading cause of death in children under the age of 24 in the US.

The Academy’s statement urged a “multipronged approach with layers of protection focused on harm reduction, which has been successful in decreasing motor vehicle-related injuries, is essential to decrease firearm injuries and deaths in children and youth.”

The Academy has free educational modules for pediatricians to guide them on how to have what can be challenging or uncomfortable conversations about firearms with families, according to Dr. Lois Kaye Lee, a pediatrician and the chair of the Academy’s Council on Injury, Violence and Poison Prevention.

“This shouldn’t be considered as something extra; it should be considered as part of the work that we do every day around injury prevention, be it around firearms, child passenger safety and suicide prevention,” Lee said.

Dr. Georges Benjamin, executive director of the American Public Health Association, told CNN the public health approach to addressing gun violence removes the politics from the issue and “puts it into a scientific evidence-based framework.”

“Physicians have a unique opportunity to engage their patients, the parents of kids or the parents themselves as individuals to make their homes safer,” Benjamin said. “We already do this for toxins under our kitchen cabinets, razor blades and outlets in the wall.”

In the emergency department at St. Louis Children’s Hospital, all patients are screened for access to firearms and offered free gun locks, as well as safe storage education, Clukies said. Gun locks can also be mailed to families, free of cost, through the hospital’s website.

“Every patient that comes into our emergency department, whether it’s for a fever or a cold or a broken arm, is asked about access to firearms,” said Clukies, adding 5,000 locks have been given out since the initiatives were started in 2021.

In a collaborative effort between trauma nurses, physicians, social workers, violence intervention experts and family partners, the hospital created a “nonjudgmental” script for doctors to follow as they ask patients about access to firearms, Clukies said.

During the screening process, pediatricians will ask parents or caretakers questions such as: Do you have access to a firearm where your child lives or plays? How is it stored? Is it stored unloaded or loaded?

“When I first started doing this, I would say, ‘Are there any guns in the home? Yes, or no?’ But I have found and learned from other experts that if you just say, ‘If there are any guns in the home, do you mind telling me how they’re secured?’ it takes away the judgment,” said Andrews, a pediatrician whose hospital, the Medical University of South Carolina, also offers free gun locks to patients.

An assortment of cable gun locks offered free of charge by the Medical University of South Carolina.

Families are asked about firearms in the “social history” phase of a patient visit, during which pediatricians will ask who lives in the home, what grade the child is in, what activities they engage in and where the child goes to school, according to Andrews. When parents indicate their firearms are not safely stored, like on the top of a shelf or in a nightstand drawer, Andrews said those are important opportunities for intervention and education about storage devices such as keypad lockboxes, fingerprint biometric safes and other types of lock systems.

It’s also important for pediatricians to understand the parents’ or caretakers’ motivation for owning a firearm to “inform the conversation about where they’re willing to meet you as far as storage goes,” she added.

Andrews and Clukies said they were pleasantly surprised by the willingness of families to discuss firearm safety, most of whom recognize it is an effort to protect their children.

“I expected more pushback than we received, which is attributed to us really focusing on how we properly word these questions,” Clukies said. “I think it’s because we turn it into a neutral conversation, and we focus on safety and prevention.”

Andrews added it is uncommon for medical schools or residencies to discuss gun violence prevention, which she says is due to the “politics around the issue.”

“Thankfully, that has evolved, and more and more pediatricians are realizing that we have to be an integral part of the solution to this problem,” Andrews said.

At the St. Louis Children’s Hospital, pediatricians followed up with patients who received a free gun lock in a research study roughly two months after they launched the initiative in the fall of 2021 to see if their storage practices changed.

The study found two-thirds of families reported using the gun lock provided to them by the hospital and there was a “statistically significant decrease” in those who didn’t store their firearms safely, as well as an increase in those who stored their firearms unloaded, according to Clukies.

But there is still much more work to be done in the medical community to fight the gun violence epidemic and scientific research on the issue is “woefully underfunded,” Andrews contended.

According to the American Public Health Association’s Benjamin, a multidisciplinary approach by policymakers, law enforcement and the medical community is essential to fostering a safer environment for children.

“Injury prevention is a core part of every physician’s job,” Benjamin said. “It’s clearly in our lane.”

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Rest isn’t necessarily best for concussion recovery in children, study says | CNN

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CNN
 — 

Sending kids back to school rather than isolating and resting may be a better way to help them recover faster from a concussion, a new study finds.

The study, published in JAMA Network Open on Friday, finds that an earlier return to school was associated with better outcomes for some children.

The study looked at data from 1,630 children ages 5 to 18 who went to nine different emergency rooms across Canada. The study found that for kids ages 8 to 18 who were recovering from a concussion, an early return to school, in two days or fewer, was associated with children experiencing fewer symptoms 14 days after their injury. That was not the case in children ages 5 to 7.

Patients who followed recommendations for a slower return to activity in the study, including being restricted from school and their electronics, took longer to recover and had more symptoms at 10 days post-injury on average than those that did not follow these steps.

Prolonged restrictions after a concussion is thought to increase a child’s risk of depression and anxiety, earlier studies have shown. The researchers believe that socialization, reduced stress from not missing too much school, and returning to a normal sleep and school schedule may play a role in helping kids recover faster. Light to moderate physical activity may also help a child recover faster.

Dr. Chris Vaughan, an author of study, said that about a decade ago doctors encouraged parents to have their kids rest and limit their brain activity to help them heal for a longer period of time.

“We didn’t have good data for that. But it seemed like the thing to do because we were helping kids avoid activities that were triggering symptoms, and so we’re trying to do our best to manage symptoms and that became the sort of standard for treatment,” said Vaughan, a neuropsychologist at Children’s National Hospital.

In the last five or six years, though, there has been a shift, Vaughan said, and the thinking is that after the first day or two of rest, some activity is good for recovery.

“We continue to need to take concussions very seriously,” Vaughan said.

In the past, “we were doing what a lot of people refer to as cocoon therapy, where you essentially put your child in a dark room and try and take away the stimulation and just have them rest. But what we learned is that shutting kids down to that extent actually slowed recovery from concussion,” said Dr. Susannah Briskin, a sports medicine doctor at UH Rainbow Babies & Children’s Hospital in Cleveland, who did not work on this study.

The pendulum has swung back to where doctors are trying to get kids to stay engaged as much as possible, and get them back to school sooner.

“I tell families the most important thing is to avoid any activities where the child could have their head struck again while they’re recovering, but it is important to get moving and not just sit around,” Briskin said.

The study, she says, supplements what some doctors are already doing, but “this was probably the earliest return that we’ve seen be helpful.” Often, Briskin said, kids are out of school about a week with a concussion.

“Based on this study that would actually be detrimental to their recovery,” Briskin said.

Most kids with a concussion will feel better within a couple of weeks, according to the US Centers for Disease Control and Prevention, but for some symptoms can last for a month or longer.

Just because they have some symptoms doesn’t mean they have to stay isolated, doctors said, but children may need accommodations. Children are often sensitive to light and noise after a concussion, thinking and concentrating can make kids feel worse, Briskin said.

“We really try to ease the burden by having kids take breaks from classes if they need to step out. We have individuals wear sunglasses if they’re having a lot of light sensitivity. If they’re having a lot of noise sensitivity, we try and avoid loud environments, such as music class, or even the lunch room or a loud assembly,” Briskin said.

In the study, the link between an early return to school and a lower number of problem symptoms was stronger in those who reported having a higher number of symptoms at first. Typical symptoms include feeling dizzy, having a headache and feeling nauseated.

Most guidance recommends people who get a concussion get a day or two of physical and mental rest and then gradually return to regular activities with some accommodations and support.

Dr. Britt Marcussen, a sports medicine physician who works with teams at the University of Iowa and who did not work on the study, said prior to this study, there’s little data to back up how to handle when students should go back to school post-concussion. Marcussen said this is one of the first papers to show that kids getting back to the classroom earlier seem to have fewer symptoms at 14 days out.

“Really this is the first paper that I’ve seen that says that early reintegration into school activities and cognitive activities may have some beneficial effect,” Marcussen said.

it is hard to know why it would be different for younger children, as the study suggested; Marcussen said it may be that the littlest kids are at a different developmental period, or just that younger children aren’t as clear about describing their symptoms. The American Academy of Pediatrics suggests doctors use a check list to ask kids about their symptoms and their severity.

“It may be just it’s harder for them to fill out the checklists and to identify how they’re feeling,” Marcussen said.

Every individual may be a little different, and not everyone who has a concussion should be back at school within two days, Vaughan said.

But generally, there are things people can do to help children, or anyone for that matter, recover from a concussion: First, people need to be protected from re-injury or activities that could do their head further harm. Vaughan said people should get good quality sleep at night, hydration and nutrition; they should even get a little bit of exercise, like going for a walk.

“Keeping a kid or student in their normal routine, as best we can, and trying to get them back into the normal routine as soon as their symptoms allow, seems to fit that model where healthy lifestyle factors really seem to support the brain’s efforts to recover and get better,” Vaughan said. “Finding the balance is really important.”

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ER on the field: An inside look at how NFL medical teams prepare for a game day emergency | CNN

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CNN
 — 

When Buffalo Bills safety Damar Hamlin dropped to the ground from a cardiac arrest earlier this month, help was by his side in under 10 seconds to administer CPR.

It wasn’t coincidence or luck. Rather, it’s the result of careful planning and practice – the execution of detailed choreography performed by the medical personnel present at every National Football League game.

Saving Hamlin’s life was the ultimate test.

“What we want is that the players are getting the same care here that they would if they were in a hospital or health care facility and that’s what the system has been set up to do,” NFL Chief Medical Officer Dr. Allen Sills told CNN Chief Medical Correspondent Dr. Sanjay Gupta on Saturday.

About 30 medical personnel are at every game, including orthopedic and trauma specialists, athletic trainers, paramedics and dentists. Sills gave CNN a rare behind-the-scenes look at the league’s medical personnel during Saturday’s playoff game between the Jacksonville Jaguars and the Los Angeles Chargers. The goal, Sills said, is to deliver hospital-quality care on the gridiron.

When Hamlin collapsed on January 2, speed was of the essence. Studies find that for every minute someone who experiences cardiac arrest and doesn’t receive CPR, their chances of survival decrease 7 to 10%.

Hamlin’s heart was restarted on the field. The 24-year-old spent more than a week in the hospital in Cincinnati, then transferred to a hospital in Buffalo before he was released home last week.

Sills said that being on the field was likely a factor for Hamlin: Survival is more likely for someone who experiences cardiac arrest in the hospital. One study found that 10 to 12% those who have cardiac arrest outside of the hospital survive to discharge, but that survival rate more than doubled for those who experienced cardiac arrest in the hospital.

“I think he was being resuscitated as he would have been in an emergency room at that moment,” Sills said.

Hear audio of medical personnel treating Damar Hamlin after he collapsed

The NFL requires all teams to have an emergency action plan, or EAP, for all player facilities, including practice fields.

The plans are filed by the teams every year and are approved by the League as well as the NFL Players Association, the players’ union, Sills said. They run drills on the plan, so when an event like Hamlin’s cardiac arrest occurs, the medical team’s choreography is close to automatic.

“The EAP was followed to a letter that night,” Sills said. “In that moment everyone knew what they needed to do, how they needed to do it and had the equipment to do it and felt comfortable.”

These plans include details about where ambulances are located, the quickest route to the hospital, where medical equipment is stored, and even what radio and hand signals will be used in case of a medical event.

While the teams are all connected by radio, the sound from the game and the crowd can be overwhelming.

“It gets loud and so having those nonverbal signs is a way for us to communicate,” explained Dr. Kevin Kaplan, Jacksonville Jaguars’ head physician. For example, using two hands as if driving a steering wheel indicates needing the medical cart, while crossing arms to make an “X” is an all-call for medical personnel.

The home team sends the plan to the visiting team a week before the game. Then, an hour before kickoff, medical teams from both teams gather to review and confirm the details in what’s known as a “60-minute meeting.”

Medical teams from the Los Angeles Chargers and Jacksonville Jaguars gathered for the 60-minute meeting ahead of kickoff on Saturday.

It’s like the NFL’s version of what happens in a hospital: Before doctors perform a procedure, the medical team gathers for a “timeout” to review who is responsible for what.

Before the football game, they identify the team physicians, athletic trainers and key trauma personnel, including an airway specialist who can place a breathing tube in moments, if needed.

In the excitement of game day, there needs to be a simple, clear way to identify who can help in case of an emergency. At any NFL game, you’ll see it: a red hat.

Dr. Justin Deaton, NFL airway management physician, wears a red hat on the sideline of the Jacksonville Jaguars-Los Angeles Chargers game on Saturday.

“That signifies me as the emergency physician, the airway physician, so that even the other team knows when I come out what my role is,” Dr. Justin Deaton told Gupta. “Once I come out onto the field, I kind of take over, I identify if the patient is either unconscious or has an airway obstruction.”

At every game, Deaton stands along the 30 yard line, just like his counterparts at other games.

“We standardize the location so that everybody knows where our airway physician is going to be located,” said Sills.

If the player isn’t breathing, it’s up to Deaton to identify who will administer CPR. If the player’s breathing is blocked and he can’t breathe on his own, Deaton may have to intubate the player on the field. In order to do so, he carries a videoscope to look down someone’s throat and an ultrasound machine.

In the event Deaton can’t get the patient to breathe through their mouth, he’s prepared to essentially do surgery on the field.

“If someone has an obstruction or significant trauma to the face and we can’t secure an airway by the mouth, we’re able to make an incision and insert that way,” he told Gupta. “I really have all the resources available here that I would have in an emergency room.”

The challenge is that they’re surrounded by chaos – not the more controlled environment of the emergency department or operation room.

“When you have a larger-than-average-sized person that’s laying flat on the ground and not able to be elevated to a certain level with extra equipment, plus cameras and other people around, those are really the confounders and things that make it more difficult to manage,” Deaton said.

In football, it’s not just about executing in the moment – it’s about anticipating. The same is true for medical personnel.

The NFL includes certified athletic trainers on its medical team to serve as spotters. They’re positioned throughout the stadium, including a booth that oversees the entire stadium, to watch the game in real time and again in replay – sometimes over and over – to immediately catch any injuries or assess those that might have been overlooked. They have around 30 different angles of the field at their fingertips.

“We watch every play probably minimally four times and then we’ll go back and watch it again,” said Sue Stanley-Green, one of the athletic trainer spotters assigned to Saturday’s game. “We just want to make sure we don’t miss anything.”

Spotters around the field at every game have different views of plays -- and potential injuries.

The spotters who sit in a stadium booth above the field are able to communicate directly with the medical team on the sidelines and direct them to concerning plays and possible injuries. They also have a unique line of communication to the referees, and the ability to stop the game for a medical timeout.

Sills acknowledges that there is always room for improvement and need to evolve.

In September, Miami Dolphins quarterback Tua Tagovailoa experienced an apparent head injury while playing against the Bills. He stumbled after being hit, but was allowed to return to the game. The incident put new scrutiny of the NFL and its policies.

Afterward, the league changed its concussion policy. Now, Sills says, “if we see something that looks like ataxia on video, (players) are done.”

Sills said he believes the NFL’s network of practices is working to keep players safe, and the league is currently reviewing the moments around Hamlin’s cardiac arrest. One aspect of emergencies that Sills wants to see more work on is privacy.

In the moments after Hamlin fell, his teammates formed “kind of a shield,” Sills said, which limited the view of Hamlin.

“I think there’s some things there that we may look at,” Sill said. “Obviously any of us would want some privacy in a moment like that.”

But when facing a test like saving a life on the field, “everything went really as well as you could have asked to have gone in the moment,” Sills said. “It’s always about the right people, the right plan and the right equipment.”

Bob Costas Damar Hamlin split for video

Bob Costas: Hamlin collapsing is not an indictment of NFL safety

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Damar Hamlin could be released from a Buffalo hospital in the next day or two | CNN

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CNN
 — 

A week after suffering a cardiac arrest while playing the Cincinnati Bengals, doctors are hoping Buffalo Bills safety Damar Hamlin is healthy enough to be released from a Buffalo hospital within 24 to 48 hours, Michael Hughes, senior vice president and chief administrative officer at Kaleida Health, told CNN on Tuesday.

Doctors are finishing tests and are identifying possible causes of the event, including whether there were any pre-existing conditions that played a role in Hamlin’s January 2 cardiac arrest.

“Hamlin is going through a series of testing and evaluation today,” Kaleida Health said in a statement Tuesday. The Buffalo General Medical Center team will also “potentially treat any pathology that may be found, as well as plan for his recovery, discharge and rehabilitation.”

Hamlin himself updated his fans Tuesday afternoon.

“Not home quite just yet,” Hamlin tweeted. “Still doing & passing a bunch of test. Special thank-you to Buffalo General it’s been nothing but love since arrival! Keep me in y’all prayers please!”

Hamlin was transferred from a Cincinnati hospital to the Buffalo hospital on Monday after doctors determined his critical condition had improved to good or fair – surpassing expectations.

“We felt that it was safe and proper to help get him back to the greater Buffalo area,” Dr. Timothy Pritts, chief of surgery at the University of Cincinnati Medical Center, said Monday.

Hamlin’s parents flew from Cincinnati back home to Pittsburgh but then flew to Buffalo. They were en route Tuesday from the Buffalo Bills’ practice facility and were expected to arrive at the hospital to see Hamlin soon.

Hamlin, a second-year NFL player, has been regaining strength over the past several days after his sudden collapse after a tackle against the Bengals in Cincinnati.

“He’s certainly on what we consider a very normal to even accelerated trajectory from the life-threatening event that he underwent,” Pritts said, “but he’s making great progress.”

Normal recovery from a cardiac arrest can be measured in weeks to months, Pritts explained. But Hamlin has been beating that timeline at each stage and is neurologically intact.

Still, Pritts said it’s too early to say when Hamlin could get back to normal life or what caused his heart to stop, saying more testing is needed.

Hamlin was sedated and on a ventilator for days after his cardiac arrest. On Friday morning, the breathing tube was removed, and Hamlin began walking with some help by that afternoon, his doctors said Monday.

The safety’s condition was upgraded Monday because his organ systems were stable and he no longer needed intensive nursing or respiratory therapy, doctors said.

“He walks normally,” said Dr. William Knight, a neurovascular critical care expert who treated Hamlin at UC Health. “He is admittedly a little weak. I don’t think that’s of any real surprise after what he went through, just regaining his strength. And that’s part of his recovery process.”

Hamlin’s release Monday meant he could return to Buffalo, which prompted even more encouragement and eagerness for some of his teammates to see him again.

“Super excited that he’s back in Buffalo and what a job that the team of docs and the medical team did out in Cincinnati, and now he’s in great care here in Buffalo. We’re happy to have him back,” Buffalo Bills head coach Sean McDermott told reporters Monday.

After seeing him Monday, McDermott said Hamlin was “tired” but seemed happy. “Happy to be back in Buffalo and around a familiar area to him. I know he’s taking it just one step at a time.”

The coach also said his team has grown since Hamlin was injured, saying such experiences nurture growth.

“We will all have grown as people, and as men in this case,” McDermott said, noting there’s a plan in place for the players and staff to visit Hamlin “at the proper time.”

“Having him nearby will give us more comfort” and inspire the team as it prepares for the postseason, McDermott said.

Although Hamlin was not with the team when they played Sunday against the New England Patriots, his support was definitely felt.

When his team scored a touchdown, Hamlin set off alarms in the ICU, Pritts said.

“When the opening kickoff was run back, he jumped up and down and got out of his chair and set – I think – every alarm off in the ICU in the process, but he was fine, it was just an appropriate reaction to a very exciting play. He very much enjoyed it,” Pritts said.

Hamlin was “beyond excited” Sunday and felt “very supported by the outpouring of love from across the league, especially from the Buffalo area. We’ve learned this week that the Bills mafia is a very real thing,” Pritts added.

The immediate medical response to Hamlin’s collapse helped save his life, and the Buffalo Bills are now encouraging people to learn how to administer CPR.

Assistant athletic trainer Denny Kellington is credited with performing CPR when Hamlin lost his pulse on the field and needed to be revived through resuscitation and defibrillation.

The medical response was part of an emergency action plan that “involves team, independent medical and athletic training staff, equipment and security personnel, and is reviewed prior to every game,” a Monday statement from the Bills read.

The team pledged support for resources including CPR certifications, automated external defibrillator units and guidance developing cardiac emergency response plans within the Buffalo community, according to the statement.

“We encourage all our fans to continue showing your support and take the next step by obtaining CPR certification,” the Bills said.

Clarification: This story has been updated to clarify Hughes’ remarks about Hamlin’s injury and recovery.



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