PHOENIX -- Watching from her couch as athletic trainers and first responders performed life-saving actions on Buffalo Bills safety Damar Hamlin, Dr. Comilla Sasson had a frank yet hopeful assessment of the steps taken that ultimately saved Hamlin's life after he suffered cardiac arrest during a game Jan. 2.
"I remember sitting there with my husband and saying, 'It's working,'" she said Monday at the NFL owners meetings. "Everything is happening like it should. And that was because there was early recognition of the cardiac arrest event, calling 911 right away, early CPR and access to an AED, or defibrillator. And if everybody had that same opportunity, just like Damar Hamlin did, we would have numbers that would be much higher in terms of survival."
Seeing the procedures learned in routine CPR and automated external defibrillator training work for Hamlin inspired not only Sasson, the vice president for science and innovation for emergency cardiovascular care at the American Heart Association, but also the NFL and nonprofit public health and patient advocacy organizations such as the American Red Cross to make sure the response carried out in Cincinnati to save Hamlin's life is present at all levels of football.
On Monday, the NFL announced the launch of the Smart Heart Sports Coalition, a collaboration with those groups to advocate for policies in all 50 states to prevent fatal outcomes from sudden cardiac arrest among high school athletes.
"It's really important to get the message out there that that was not a miracle that night," said Doug Casa, CEO of the Korey Stringer Institute. "Ninety percent of athletes that have AED access within two to three minutes survive a cardiac arrest. If you have emergency action plans and access to AED athletic training services, we expect that outcome. That's what should happen at the high school sports field. That's what obviously happened at the NFL level with Damar, but that's the expectation we have for 8 million high school athletes in America and what we're striving to work towards together."
The coalition, which is also partnered with Hamlin's Chasing M's Foundation, advocates for the implementation of three best practices to prevent death: widely distributed emergency action plans for each high school athletic venue that are posted, practiced and updated annually; clearly marked AEDs at each athletic venue or accessible within three minutes of anyplace a high school team practices or holds competitions; and CPR and AED education for coaches.
"I'm honored to support the NFL's work to encourage all 50 states to adopt policies to protect youth," Hamlin said in a statement announcing the effort. "This work pushes forward the idea that every high school should have an athletic emergency plan, coaches should be CPR and AED trained and athletic fields should have clearly marked AEDs within a moment's reach. These efforts can help save the lives of student athletes impacted by sudden cardiac arrest."
Only seven states have implemented all three best practices, and as many as 23,000 people under age 18 experience sudden cardiac arrest outside of hospitals, according to an NFL news release. It's the leading cause of death for student-athletes.
The goal of the coalition is to pass legislation on the state level and implement these policies within the next three years. The group sent letters to governors of 43 states where it says additional policies are needed. The NFL is committing more than $1 million, including $20,000 grants to each club to promote CPR education and other efforts to implement the action steps in their communities, including purchasing and maintaining AED equipment.
More than a decade ago, a similar coalition helped pass youth concussion legislation, known as the Zackery Lystedt Law, across the country, requiring policies for the management of concussion and head injury in youth sports. The Smart Heart Sports Coalition hopes to have similar success introducing and persuading states to adopt legislation that reduces fatal sudden cardiac arrest in high school athletes.
"We have an opportunity to really equalize the playing field and make sure that every single person has access to that information, not just the students themselves but their families," Casa said. "And I think that's a really important piece of it as we start thinking about how do we make sure that survival increases? It's not just making sure that the people who have had the training continue to get certified. That's not what we're looking for here. We're looking at getting grassroots public education and awareness to anyone and everyone who wants that information."