The horrific injury to Buffalo Bills safety Damar Hamlin on Monday Night Football has spurred renewed attention to sports safety in Texas. The state has helped lead the way in addressing safety for student athletes, advocates say, after the Legislature passed a law in 2007 requiring that every school have an automated external defibrillator, or AED, on its campus.
“Texas did an amazing thing, which most states don't do: It gave the opportunity for schools to be equipped with these life-saving devices,” said Martha Lopez-Anderson, the executive director of Parent Heart Watch, a national organization that advocates for ways to prevent sudden cardiac-related deaths among America’s youth. Members of Parent Heart Watch testified in favor of the legislation in Texas in 2007.
Medics used an AED and performed CPR to help resuscitate Hamlin before an ambulance took him to the hospital, action that has been credited with saving the 24-year-old’s life after he collapsed. As of Wednesday afternoon, he remained in critical condition but showed signs of improvement, the Buffalo Bills said in a statement.
But the injury to Hamlin, who lay motionless after collapsing following a tackle on a wide receiver, has also prompted discussion on what else can be done to prevent premature deaths in student athletes.
The Texas law passed after Matt Nader, a football player at Westlake High School in Austin, collapsed during a football game after suffering cardiac arrest. It’s unclear how many times an AED has been used since 2007, but the University Interscholastic League, the governing body for high school sports and other competitions, said they have been used five times since the 2019-2020 school year. A reporting requirement that went into effect in 2019 requires that all UIL member schools file a report after an AED is used “in conjunction with any UIL event, practice and competition, utilizing the online reporting form available on the UIL website.”
Though she praised the Texas law, Lopez-Anderson said states need to do more to prevent tragedies in school sports.
“What is important to highlight is not only the importance of having these lifesaving devices accessible and properly maintained, but I think what is really, really important to highlight is the importance of cardiac-emergency response plans that are written and well-practiced,” she said. “So what happens when an AED is used and there's a cardiac emergency? What if you don't have a plan? How do people know what to do?”
The batteries and pads on AEDs also need to be replaced after a few years, according to vendor websites. Pads can last between two and five years depending on the brand, according to The AED Source, while batteries have a longer shelf life.
Lopez-Anderson said it’s unclear if schools take those requirements into consideration.
“It is not only the importance of having these lifesaving devices accessible, [but] properly maintained,” she said.
Demand for more screening
Dr. Alexander Postalian, a cardiologist at the Texas Heart Institute who has participated in research studies on the screening of high school athletes, said more screening is needed to detect heart conditions. He told The Texas Newsroom that it’s still unclear whether Hamlin’s injury is the result of a pre-existing condition, or a collision that caused his heart to stop beating after impact, a condition called commotio cordis.
He said that most heart-related injuries aren’t the result of one hit or blow to the chest.
“Most cardiac arrests that happen to athletes are due to a preexisting condition that gets worse with physical activity,” he said.
Postalian said screenings won’t always detect heart conditions, and the current debate in the medical community is over what type of tests should be conducted.
“There's a lot of debate in the medical community as to who should be screened and with what tests, because some tests may not be good enough to detect the condition,” he said.
“We've actually participated in research of screening high school athletes with a cardiac MRI, which would show a lot of these high-risk cardiovascular conditions,” he continued. “The thing is that once you start doing population assessments, it's basically how many tests you did and how many lives it saved. You have to screen a lot of people to save a life. So maybe the answer is in targeted screening the sports that are the highest risk.”
When asked about Postalian’s views on additional screening, the UIL pointed to a 2013 requirement that students and their parents sign a form every year that explains the symptoms of cardiac conditions and provides other medical information about cardiac irregularities. The UIL representative said matters on cardiac health and screening are deferred to its Medical Advisory Committee, which is comprised of physicians and trainers.
For Lopez-Anderson, who lost her 10-year-old son in 2004 to an undiagnosed heart condition, the “pie in the sky” would be universal testing for every student, regardless of whether they are in sports.
“What we need is the standard of care should be changed,” she said. “We need for this not to be whether somebody opts in or opts out [for screening], it should be every child, not just athletes. Every youth should be screened. In the ideal world … we screen kids at birth when they enter school, middle and high school.”
Got a tip? Email Julián Aguilar at jaguilar@kera.org.You can follow Julián on Twitter @nachoaguilar.
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