EAST LANSING, Mich. – When Buffalo Bills’ safety Damar Hamlin went into cardiac arrest, coded and was revived on the field during a game against the Cincinnati Bengals on Jan. 2, 2023, emergency action plans, also known as EAPs, in athletics came to the forefront of national discussion. This dialogue has brought questions when it comes to athletic trainers, medical staffs and their preparedness for emergency situations.
At Michigan State, there are 700 to 800 athletes a year, across 23 varsity sports teams, who are playing and practicing every day, and they are all under the care of Dr. Jeff Kovan. He has spent over two decades as MSU’s director of Sports Medicine and Performance. During this time, Kovan has seen his share of bumps and bruises, but nothing like what transpired that fateful night in Cincinnati. For Kovan and many other medical professionals, it’s a constant learning experience in the field to prepare themselves and their staffs for the time the EAP has to be used.
“In athletic medicine, especially at the collegiate and professional level, there’s a lot of time and energy put into the education for all of us, as healthcare providers, and how to best take care of and serve for athletes of every type,” Kovan said. “You need to be and have to be sure that you are prepared and hope that you never have to implement it.”
Kovan said what happened to Hamlin is more often seen in youth athletes, but can occur to anyone, anywhere, and is constantly on the minds of medical professionals.
“We all see bad injuries,” Kovan said. “But athletes who become paralyzed or potentially have a sudden death experience or something close to that is our biggest fear in sport.”
When it comes to emergency protocol at Michigan State, the athletic training and medical staff have all of the equipment needed and ready from athletic tape and splints to spine boards and AEDs.
A major part of EAPs that have received a lot of attention since the Hamlin incident has been the use of these AEDs, which are short for Automated External Defibrillators. These machines are used to help shock a heartbeat back into sinus rhythm and on the night Hamlin suffered his cardiac arrest an AED was critical in saving his life.
According to Kovan, there is an AED at every single athletic facility and athletic training room on Michigan State’s campus. This includes the Breslin Center, Munn Ice Arena, Spartan Stadium and all of the recreational centers.
Also, Kovan said every coach at Michigan State is trained to not only administer CPR, but also on how to use an AED. Many athletic department staff members have also asked to receive training, or additional training, when it comes to CPR and AEDs.
Sally Nogle, Ph.D., is the director of Athletic Training as well the head athletic trainer in her 39th year at Michigan State. Nogle believes every person should learn how to administer CPR and operate an AED, especially considering how easy they are to use.
“For people who haven’t been trained in them, if they would just grab that machine and open it up, it will tell you where to put the pads and it’ll tell you how to check whether you need to shock or not,” Nogle said. “They figured out a real nice way for lay people to do it as well as us.”
Both Kovan and Nogle said the athletes with the highest risk of having a sudden cardiac event are men’s basketball players and “really tall, lean, long athletes.” Those players, along with others who have medical or family histories for heart-related issues, are screened a bit more thoroughly than other athletes with EKGs and echocardiograms. However, Nogle said despite screening efforts, what happened to Hamlin isn’t predictable.
“It was an unfortunate hit, but that’s the thing with screening,” Nogle said. “(Hamlin) was fine and they still had this happen, so you can screen people all you want but it doesn't mean that this still isn’t going to happen.”
Rod Scott, MSU’s head football athletic trainer, spent 15 seasons as a member of an NFL athletic training staff. He said it is standard in pro and collegiate athletics to have a 60-minute medical meeting before every event.
During this meeting, every person involved in player health and safety reviews the EAP and they go over who has what role, where all the equipment is located and what the signals are.
Scott also has a motto, called the Seven Ps. It goes, “Prior, proper preparation prevents piss poor performance.” He said that by using this motto, neither he nor his staff ever have to be scared or nervous to do their job in the field.
“For us as athletic trainers and medical staffs, when you do have a situation like Damar Hamlin, that’s our Super Bowl,” Scott said. “So when you’re prepared and you practice and the situation comes, you just act.”