Players on the field, fans in the stadium, American Football fans, and people who know and care little for the sport were stunned by the on-field collapse of a young player from the Buffalo Bills, Damar Hamlin, after he tackled a player from the Cincinatti Bengals during Monday Night Football on 1/2/2023.
Fortunately for Mr. Hamlin there was an ambulance nearby with personnel trained to deliver CPR and quickly use an AED. As a result, he beat the odds, survived the often-fatal episode, and (as of this spring) appears to have no serious sequelae. Mr. Hamlin is living testimony to the importance of early defibrillation (1-3 minutes from onset) in promoting survival from cardiac arrest.
When I was the medical director of the EMS system in Kitsap County, Washington State, along with EMS staff, paramedics, and EMT’s, we developed one of the first programs in the country, training ordinary citizens in the use of AED’s that were placed in gymnasia, work-out clubs, swimming pools, malls, public buildings, and onboard Washington State ferries.
It was about this time (1996) on a trip to Italy that I carried an AED, as well as a series of instructional slides, to present my spiel about the life-saving benefits of early defibrillation. I was headed back to Vetriano, a small, somewhat isolated village that sits on a hillside about 20 minutes from ambulance personnel headquartered in the Serchio River valley, where Susie and I had purchased an old, run-down stone house. I thought that the village was the perfect place for an AED with citizens trained to use it. In my memoir, Questions for the Heart, I recount the warmly received presentations delivered by me and my friends Iva and Luciano to the locals, plus the not-so-warmly received and comical interactions with the cardiology department at a nearby hospital. Despite our efforts as the pied pipers of defibrillation, the upshot was that it would take a few decades before AED’s would be placed in Vetriano and other Tuscan villages.
Now flash forward to 2020.
On a phone call to Iva and Luciano, who had made the presentations with me in 1996, they were excited to tell me the story of their 50-ish year-old nephew, Antonio, who was in the mountains above the village, searching for Porcini mushrooms, when he began having severe chest pain and difficulty breathing. He made it to his four-wheeler, drove himself down the hillside to the home of his daughter, and collapsed. His daughter was one of the locals trained in the recently allowed AED program. She was a young girl in 1996 when her great uncle and aunt and I made our presentation to the village.
She and others began CPR on Antonio and called the ambulance. The AED was connected to his chest, the machine read the heart rhythm and advised shocking the victim. The daughter pressed the button to deliver the electricity. Antonio survived the arrest. He was taken to the hospital where he was stabilized and eventually underwent successful cardiac bypass surgery. He remains alive and active to this day. Like Damar Hamlin, the outcome likely would have been tragic had Antonio not been rapidly defibrillated.
You can find the complete recounting of the episodes experienced in 1996 by my friends and me in my book, Questions for the Heart. In fact, the title of the book is based on the comical interaction with the Cardiology department of the Via Reggio hospital when we were making a pitch for AED placement in Tuscan villages. Thank you for reading.
