Wyldnwoody44

These guys don't play defense

Crap crap game, unacceptable really.

That building was ELECTRIC, I haven't seen a game that loud in ages. The refs were hearing it, the players were feeling it, I saw Tuch look up and smile when the crowd really got going. This team is coming together and they are exciting to watch.

What a game boys!!!

That "trip" was soft as hell. This team came out FLAT in the 3rd

Ok so I'll be at UP around 430, is there a name for the reservation?

Our team had 2 live saving moments over the last 2 shifts... This job beats you down and a lot of people are entitled pricks. But those days when you make a difference really do keep you going.

Honestly, I believe Damar will be playing for the Bills again next year. This is a very remarkable turnaround. Unless they find some pre-existing condition, I think he'll be back. Wouldn't blame him one bit to retire after this, but I don't think it's in his DNA.

I wish I could get there and it would make a hell of a story. But I'm not sure I think we're even making it to the SB, let alone winning it. No real reasoning, just gut feel. The team showed enough this year that I'm Proud to be a Buffolonian either way.

Yes please, my gal is supposed to work until 3 tomorrow and would be coming from Olean area so we may be a tad behind, she's trying to switch her day to have it off completely. But we'll be there We'll see you tomorrow afternoon 😊

Cool, I'd like to meet up. I'm not sure that I've been to Union pub before. Where do you guys park? And is it walkable to the arena from there?

Man, how much easier this would seem if we didn't have an 8 game losing streak, or at least have had some OTL points in there.

Yeah, that's why I'm not trying to read too much into it and giving more of a perspective of things that typically happen in these situations, and similar situations that I have treated in the past. He may be an all world player, but the treatment pathways don't vary quite as much between patient to patient, sure the access is much quicker and etc, but once attended to there are fairly solid protocols in place Nationwidem

They prone patients in the ICU, but typically they only prone when they're not oxygenation well on the ventilator. I am unaware of the practice of proning when the respiratory status is good. All this said, I'm not an ICU/Intensivist so maybe there is some other reason they're doing it that seems less worrisome.

That would be reasonable, but if it was just an AED, you just stop CPR and let the machine detect the rhythm and deliver the shock, they're amazing in how accurate they are that you don't need a trauma team to run an ACLS protocol. Either way, I am 1000% confident those on the field had all the medical training and ability to handle it and I'm confident it was handled as best as humanly possible outside the hospital setting.

Are we planning on meeting beforehand anywhere at all?

Yeah, there are some inconsistencies with the story and we don't know exactly what happened on the field. I know our ems does a lot of wonky stuff sometimes especially in critical situations; you multiply that by 8,000,000 in this situation and they may have been overly aggressive on the field. An aneurysm or dissection seems less likely as well as a carotid issues or a cervical issue, I don't think he'd stand up if it was neuro/cervical They probbaly just placed an AED and they may have multiple shocks in between CPR, but we don't know exactly.

Either he has the worst timing on the planet with that hit, or there's is something that caused his young healthy heart to go into a deadly arrhythmia. It's not a 100% given they will do it, but putting in an Implantable defib would be there as a failsafe in case this were to ever happen again. At the first instance of a deadly arrhythmia a defib would shock and keep this scene from happening ever again.

In Vfib, the electrical currents sent to the heart are jumbled up, there are electrical gradients that make the heart run through bundles in certain areas of the heart (controlled by + and - ions with potassium, magnesium, chloride, etc) When Vfib occurs the bottom part of the heart isn't pumping at all, the Ventricles (bigger chambers) are needed to pump out blood and the bundles essentially aren't working. By Defibrillating at a certain number of Joules, you essentially are sending currents to that bundle system to reorganize and start working the correct way to make the heart beat In sync. Sometimes MI (heart attack) can cause this or a significant electrolyte abnormality can be reversible causes of arrythmias, in this case it was due to trauma which is a rare phenomenon but still caused the Ventricles to not get sufficient current and go into this rhythm, the Defib corrects this, although it sometimes can take multiple shocks.

Yes, this is nearly 100% Vfib from impact. Even his presentation of standing up and collapsing fits the picture of Vfib arrest. With Vfib, the heart is pumping as close to 0% as possible without being asystole. An AED senses this and delivers a defibrillation which is the #1 thing along with CPR. It appears as if everything was handled exactly as it should have been mecially on the scene. The good news is that mortality of Vfib from trauma is lower than mortality from a Vfib arrest with a patient with previous cardiac issues (being 24,hopefully means he had none that we know of) The hypothermia will protect any further cardiac tissue damage and the will lost likely wean him off the vent tonight/tomorrow. My fingers are crossed that the immediate interventions did what they should do and Damar will come through with only a couple of broken ribs from the CPR and a new shiny implantable defibrillator. I don't mind giving my medical thoughts on this, I live for this stuff, as corny as that sounds. I also don't want to wildly speculate on the health of a stranger, but at least come at it with some grounded medical basis 😊

So if his pulse returned to a sinus rhythm on its own then that is great news. Once intubated and put on a vent, the machine can actually trigger when a patient is taking their own breaths and there are many settings that can be adjusted to help with resp support instead of full on breaths. But for the hypothermia protocol and comfort the patient will stay sedated and on the vent for probably 48 hours. This is very highly likely a Vfib arrest with the timing of the hit being in the microsecond that it needed to cause this. Vfib has a poor prognosis in general. The fact that they got the AED and CPR going so fast may be the only saving grace. The main issue with Vfib is that anoxia occurs immediately and each minute that goes by is crucial in the outcome, so idk how fast they recognized it and started ACLS protocol on the field. I suspect that Hamlin will have a defibrillator placed at some point, the Vfib arrest mortality rate is still over 50% so we're not out of the woods, I am hoping he pulls through. Still just so absolutley crazy to think this all happened.

I think what's even scarier about this is that the hit didn't look all that ominous at first.

There's stable, fair, serious and then critical. It's not a good condition. There is a high likelihood of death and imminent death without major interventions (intubated, CPR, etc) Even if he lives through this, whatever the cause was, he will most likely never play again and may have some deficiencies in cardiac output and brain function. I hope I'm wrong, but critical condition is never a phrase I like to hear or tell any patient family members.

Yes, typically I will intubate a patient that had a cardiac arrest, unless they ROSC (return of heartbeat) and then are awake and talking. It's very protective of the heart and to prevent any anoxia (lack of 02)for the brain. Also hypothermia protocol may be used to cool the body to protect heart tissue. Jesus, just talking about this gives me chills and I deal with this every day 😭😭😭 Agreed, and Burrow with Josh showing a true embrace, not staged crap. There's a real fear in this situation and you saw both teams shared in it.