Damar Hamlin

[Anonymous]

ICU nurse here and agree with the MD. We don't prone people routinely at all. It's done for ARDS/ALI or as a last ditch effort for people who are not responding to ventilation.
(Not saying this is last ditch for him but by no means is proning routine).

[Anonymous]

Anonymous wrote:In case anyone wonders why not showing footage of him on the field is important, the uncle talked about how Damar’s 7 year old brother was watching on tv with the family and couldn’t stop screaming.

Awww...he and his brother seemed close. The younger brother idealized him.

I really hope he pulls through. If only for his parents, his brother and the rest of his extended family.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

This is such good news. Obviously a long way to go but, with the initial updates, I was really worried that things might get worse instead of better.

His uncle was so composed and calm despite his sleep deprivation and taxing ordeal. But there was really nothing in his words that made me feel better about the outcome. In fact, the lack of quick progress is not a good sign. It was reported that he was ventilated in a prone position which is concerning for acute lung injury, which is always a worrisome sign. Ugh. The lung injury could be secondary to cpr, but in any case, it means that this is more complicated that I was hoping.

Actually several medical professionals have come out and said the prone position is not unusual, it takes some of the pressure off the lungs, so they aren’t working against gravity. Part of the healing process. They seemed more concerned about the the need to resuscitate a second time at the hospital.

I’m a physician and the proning is concerning. It means there is lung damage that the team is trying to reverse. Hopefully it is from primarily from cpr or resuscitation efforts (trauma from cpr, massive fluid boluses) and not cardiac dysfunction. Proning is done for patients with ards, acute respiratory distress syndrome, and in general, it’s a poor prognostic indicator, though his youth and general health is definitely on his side. His team would feel much better if he didn’t have ards. Second cardioversion is also concerning - if this was commotio cordis, the heart muscle is not damaged in the initial insult, so the second bout of what I assume was an arrhythmia means there was something else that caused it. Everyone is saying it’s likely commotio cordis, but his team will make sure there is nothing else going on. It could be that he has a genetic predisposition to arrhythmia, a structural defect, long qt, etc. I’m not sure how much the nfl screens players. In Italy, a player died on the soccer field from a cardiac arrest and they now have super stringent screening for professional soccer players.

They are now saying the uncle misspoke and he was not resucitated a second time at the hospital.

[Anonymous]

Re prone: I understood that we learned of the significant advantage of this position during the height of covid. My healthy, athletic, 25 yr old cousin was put to sleep, ventilated, max ox, paralytic, prone, for 40 days with covid (new delta, before he was eligible for the vax). During that time, they worked to pull back his ox and meds but twice when the tried to turn him from prone (to supine), he coded. Back to prone and he rallied (slightly). Point is, prone was said to have absolutely saved his life (among other things).

[Anonymous]

I thought I read somewhere the prone position was the take pressure off his lungs possibly from any damage done by the CPR. CPR done right will break ribs, it’s pretty violent.

[Anonymous]

Anonymous wrote:Re prone: I understood that we learned of the significant advantage of this position during the height of covid. My healthy, athletic, 25 yr old cousin was put to sleep, ventilated, max ox, paralytic, prone, for 40 days with covid (new delta, before he was eligible for the vax). During that time, they worked to pull back his ox and meds but twice when the tried to turn him from prone (to supine), he coded. Back to prone and he rallied (slightly). Point is, prone was said to have absolutely saved his life (among other things).

Oh my goodness, this sounds horrible. May I ask how your cousin is doing now?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Re prone: I understood that we learned of the significant advantage of this position during the height of covid. My healthy, athletic, 25 yr old cousin was put to sleep, ventilated, max ox, paralytic, prone, for 40 days with covid (new delta, before he was eligible for the vax). During that time, they worked to pull back his ox and meds but twice when the tried to turn him from prone (to supine), he coded. Back to prone and he rallied (slightly). Point is, prone was said to have absolutely saved his life (among other things).

Oh my goodness, this sounds horrible. May I ask how your cousin is doing now?

thank you. he had lots of issues from the procedures (he had a trac put in, feeding tube, was jaundice from one med, hi A1C from another, etc.) About 18 months later and rehab, he's finally essentially healthy and gainfully employed. Biggest lingering issue is paralysis in some fingers (big improvement from entire are paralysis -- a byproduct of being prone for so long). Overall, a walking miracle, according to his family.

[Anonymous]

“Neurologically intact” Has opened his eyes. Has squeezed the hands of loved ones. This is hugely positive news. Still a long road.

[Anonymous]

Anonymous wrote:“Neurologically intact” Has opened his eyes. Has squeezed the hands of loved ones. This is hugely positive news. Still a long road.

This is the news I needed to hear today. This news is so encouraging.

[Anonymous]

Saw the positive news this morning and felt huge relief. Happy for him and his family.

[Anonymous]

Anonymous wrote:I thought I read somewhere the prone position was the take pressure off his lungs possibly from any damage done by the CPR. CPR done right will break ribs, it’s pretty violent.

Lungs work on a basic level based on 2 things - ventilation and perfusion (blood flow). The lungs vary in efficiency of gas exchange and blood flow depending on the area (upper lower etc) and the effect of gravity and pressure, ie position. You can maximize ventilation or perfusion, but without the other, it’s not effective. So you can provide 100% oxygen at a high pressure, but if there’s not adequate blood flow because of a clot or packed in pneumonia, that oxygen won’t go to the heart and then the brain.

You can think of it as kind of a Venn diagram and you want a big overlap area to optimize the ventilation and perfusion ratio. Putting patients prone does several things to increase the match and the overlap area. It is difficult protocol to follow, especially for larger patients. There are so many monitors and tubes and lines that can get tangled and dislodged when turning a patient prone, and moving them can cause hemodynamic instability that causes all the alarms to sound and can be scary. It’s not as simple as turning someone over on their tummy. It wouldn’t have been done if he didn’t need significant vent support.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I thought I read somewhere the prone position was the take pressure off his lungs possibly from any damage done by the CPR. CPR done right will break ribs, it’s pretty violent.

Lungs work on a basic level based on 2 things - ventilation and perfusion (blood flow). The lungs vary in efficiency of gas exchange and blood flow depending on the area (upper lower etc) and the effect of gravity and pressure, ie position. You can maximize ventilation or perfusion, but without the other, it’s not effective. So you can provide 100% oxygen at a high pressure, but if there’s not adequate blood flow because of a clot or packed in pneumonia, that oxygen won’t go to the heart and then the brain.

You can think of it as kind of a Venn diagram and you want a big overlap area to optimize the ventilation and perfusion ratio. Putting patients prone does several things to increase the match and the overlap area. It is difficult protocol to follow, especially for larger patients. There are so many monitors and tubes and lines that can get tangled and dislodged when turning a patient prone, and moving them can cause hemodynamic instability that causes all the alarms to sound and can be scary. It’s not as simple as turning someone over on their tummy. It wouldn’t have been done if he didn’t need significant vent support.

Thanks for the explanation! I guess whatever they did worked as he awake. I even read (on reddit so grain of salt, I guess) taht he was able to communicate in writing and his question was “did we win?”. And the doctor replied “YOU won.”

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I thought I read somewhere the prone position was the take pressure off his lungs possibly from any damage done by the CPR. CPR done right will break ribs, it’s pretty violent.

Lungs work on a basic level based on 2 things - ventilation and perfusion (blood flow). The lungs vary in efficiency of gas exchange and blood flow depending on the area (upper lower etc) and the effect of gravity and pressure, ie position. You can maximize ventilation or perfusion, but without the other, it’s not effective. So you can provide 100% oxygen at a high pressure, but if there’s not adequate blood flow because of a clot or packed in pneumonia, that oxygen won’t go to the heart and then the brain.

You can think of it as kind of a Venn diagram and you want a big overlap area to optimize the ventilation and perfusion ratio. Putting patients prone does several things to increase the match and the overlap area. It is difficult protocol to follow, especially for larger patients. There are so many monitors and tubes and lines that can get tangled and dislodged when turning a patient prone, and moving them can cause hemodynamic instability that causes all the alarms to sound and can be scary. It’s not as simple as turning someone over on their tummy. It wouldn’t have been done if he didn’t need significant vent support.

Thanks for the explanation! I guess whatever they did worked as he awake. I even read (on reddit so grain of salt, I guess) taht he was able to communicate in writing and his question was “did we win?”. And the doctor replied “YOU won.”

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I thought I read somewhere the prone position was the take pressure off his lungs possibly from any damage done by the CPR. CPR done right will break ribs, it’s pretty violent.

Lungs work on a basic level based on 2 things - ventilation and perfusion (blood flow). The lungs vary in efficiency of gas exchange and blood flow depending on the area (upper lower etc) and the effect of gravity and pressure, ie position. You can maximize ventilation or perfusion, but without the other, it’s not effective. So you can provide 100% oxygen at a high pressure, but if there’s not adequate blood flow because of a clot or packed in pneumonia, that oxygen won’t go to the heart and then the brain.

You can think of it as kind of a Venn diagram and you want a big overlap area to optimize the ventilation and perfusion ratio. Putting patients prone does several things to increase the match and the overlap area. It is difficult protocol to follow, especially for larger patients. There are so many monitors and tubes and lines that can get tangled and dislodged when turning a patient prone, and moving them can cause hemodynamic instability that causes all the alarms to sound and can be scary. It’s not as simple as turning someone over on their tummy. It wouldn’t have been done if he didn’t need significant vent support.

Thanks for the explanation! I guess whatever they did worked as he awake. I even read (on reddit so grain of salt, I guess) taht he was able to communicate in writing and his question was “did we win?”. And the doctor replied “YOU won.”

The doctors were interviewed and said it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I thought I read somewhere the prone position was the take pressure off his lungs possibly from any damage done by the CPR. CPR done right will break ribs, it’s pretty violent.

Lungs work on a basic level based on 2 things - ventilation and perfusion (blood flow). The lungs vary in efficiency of gas exchange and blood flow depending on the area (upper lower etc) and the effect of gravity and pressure, ie position. You can maximize ventilation or perfusion, but without the other, it’s not effective. So you can provide 100% oxygen at a high pressure, but if there’s not adequate blood flow because of a clot or packed in pneumonia, that oxygen won’t go to the heart and then the brain.

You can think of it as kind of a Venn diagram and you want a big overlap area to optimize the ventilation and perfusion ratio. Putting patients prone does several things to increase the match and the overlap area. It is difficult protocol to follow, especially for larger patients. There are so many monitors and tubes and lines that can get tangled and dislodged when turning a patient prone, and moving them can cause hemodynamic instability that causes all the alarms to sound and can be scary. It’s not as simple as turning someone over on their tummy. It wouldn’t have been done if he didn’t need significant vent support.

Thanks for the explanation! I guess whatever they did worked as he awake. I even read (on reddit so grain of salt, I guess) taht he was able to communicate in writing and his question was “did we win?”. And the doctor replied “YOU won.”

Thanks. I needed a good cry today!