Recordings Document a Frantic Effort To Save Bills Player

Moments after Damar Hamlin, Buffalo Bills defensive back, collapsed on Monday night in Cincinnati, radio traffic rang with urgency.

“I don’t like how he went down,” one person said on a channel that appears to have included medical personnel on the sidelines.

Seconds later, as the gravity of Hamlin’s condition became clearer, another person was more emphatic.

Sign up for The Morning newsletter from the New York Times

“We’re going to need everybody,” he declared. “All-call, all-call” — the equivalent of a red alert.

The first person cut back in: “Call, bring everybody. Everyone needs an airway doctor. Bring the cot with the medics.”

The recordings of the pleas were posted on a public website that tracks emergency radio traffic. They marked some of the first urgent moments of the emergency response to a life-threatening crisis that rocked the NFL and stunned fans at Paycor Stadium and millions more watching “Monday Night Football.” For about a half-hour at the stadium, a small army of doctors, athletic trainers and emergency workers rushed to save Hamlin, who went into cardiac arrest after he took a hit to the chest while tackling a Cincinnati Bengals receiver.

On Thursday afternoon, doctors at University of Cincinnati Medical Center said Hamlin was “awake and breathing,” and though he could not speak because of his breathing tube, he asked in writing who had won the game between the Bills and Bengals.

The NFL, the Bills and Hamlin’s family have not definitively said what caused the 24-year-old player’s heart to stop beating, though the league’s chief medical officer, Dr. Allen Sills, said this week that it “certainly is possible” it was because of the blow to the chest. But photographs, videos and audio recordings of emergency workers talking on radio channels make clear the severity of Hamlin’s condition and the efforts to keep him alive.

For example, a colleague calls at 9:20 p.m. to ask for an attachment measuring carbon dioxide levels.

“We do have the other monitor with us,” a person responds.

The first person answers emphatically: “I need an end-tidal CO2 now, per the doc.”

When he is told that the device, which helps measure how well a patient is breathing, is on the way, he barks back: “Yeah, you need to step it up.”

The first minutes in Cincinnati provide a window into how the NFL prepared for an episode like the one at Paycor Stadium — a crisis that people around football both privately saw as inevitable and hoped would never come. The NFL and its teams are the stewards for a violent sport that relies on many collisions, but makes billions of dollars. They ensure that there are dozens of medical personnel at every game. Those people undergo extensive training so they can follow detailed protocols, some of which are mandated by the league’s collective bargaining agreement.

Hamlin was kept alive by an airway management physician on Monday. This doctor, who is a specialist in emergency medicine and anesthesiology and is on hand in the event that a player has difficulty breathing or needs to be intubated, can be identified using a red cap. Hamlin had already received CPR by Monday when he was transferred to an ambulance. According to the Bills his heart had been restarted.

“There’s an old joke: If you’re going to have a cardiac arrest, have it at an airport or a football stadium,” said Dr. Robert Glatter, an emergency medicine physician at Lenox Hill Hospital who worked on the sideline at New York Jets home games for five seasons. “If you’re on the sidelines and you go down, if you’re a photographer, whatever you’re doing, your expectations of survival dramatically increase because of all the experts and equipment around.”

According to the NFL, there are approximately 30 doctors, trainers, and other specialists present at games. The teams have some associates such as the orthopedists, trainers, and primary care physicians. They are supported by neurotrauma specialists who treat concussions, including paramedics. Dentists. Ophthalmologists.

Many of them communicate using hand-held radios. NFL stadiums host a network of communication networks that serves everyone on game day, including radio and television broadcasters, coaches with headsets, and emergency responders. The New York Times obtained transmissions concerning Hamlin from a public website which records emergency radio traffic. They also match the sequence of events on the recordings, which helps to confirm their authenticity.

It was often an immediate response. Emergency workers spread word about the decision to delay the game, sought supplies, and requested escorts to hospital. In one instance, a Bills doctor was asked to travel to the airport to join the team on its return flight.

Two minutes after Hamlin’s ambulance left the field, radio traffic received a call requesting help from emergency personnel.

“I need another medic in the back,” someone is heard saying. “We are right outside the gate,” he adds a few moments later.

Radio transmissions indicated that local law enforcement officials expected the ambulance would leave the stadium within minutes. Radio traffic indicated that the ambulance didn’t leave the stadium for the hospital until after 9 :23 p.m. The ambulance remained there more than 10 minutes after it left the field. At least one news report said that officials wanted to wait for Hamlin’s mother before departing the stadium, but the radio traffic suggests she traveled separately to the hospital.

While the NFL refused to comment on the delay, it is possible that Hamlin suffered additional complications while in the ambulance. Emergency workers might have preferred to repair a damaged breathing tube while the ambulance is parked and not on bumpy roads. According to them, ambulances are as equipped as emergency rooms.

“Once the pulse is back, you want to transport him as soon as possible,” said Glatter, the emergency medicine physician. “Sometimes, they delay transport if a patient is crashing. It can happen where one of the paramedics will hold the driver until he’s more stable.”

In the judgment of the NFL, Monday’s emergency and its aftermath were at once frightening and vindicating, evidence that detailed planning could — maybe — limit football’s fallout.

Dr. Matthew Matava, an orthopedic surgeon at Washington University in St. Louis who was the head team doctor for the Rams until they moved to Los Angeles in 2016, said the league’s preparations for such emergencies were “incredibly thorough.”

Matava said however that physicians, athletic trainers, and other emergency personnel often pay attention to the injuries most likely in any NFL game, such as hamstring ruptures or ligament tears, concussions, and concussions. Although rehearsals and meetings routinely cover the possibility of a cardiac emergency, Matava said, “it is not the top one, two or three things that we’re going to think about as far as the most common injuries.”

However, teams were still concerned and spent some time in the preseason practicing what to do in case of cardiac arrest.

“We get down to the details: how you access the chest, how you open the jersey and the shoulder pads, when do you remove the helmet and shoulder pads, who is doing CPR, who is putting on the defibrillator pads,” said Dr. Jonathan A. Drezner, a team doctor for the Seattle Seahawks and the director of the Center for Sports Cardiology at the University of Washington. “All of these are fine details that we discuss and hope we never have to live in real time.”

Although the league and its players union have long feared a cardiac emergency in players, the mandate for an airway specialist is relatively new, reflecting football’s risks and heightened recognition of its perils.

Similar situations have occurred in other professional leagues. Matava assisted Chris Pronger (a St. Louis Blues defenceman) when a puck struck his chest and caused his heart to stop. Pronger, who survived, was found to have suffered commotio cordis, in which a severe blow to the chest at a precise moment in the heart’s rhythm can stop its beating.

“It’s not so much if, but when, you’re dealing with emergency preparedness for sports injuries like this, especially with the number of collisions and the force involved with NFL football,” Matava said.

© 2023 The New York Times Company