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Damar Hamlin Showing Signs of Progress

— Hamlin's doctors confirm he is awake and his neurological function appears intact

Ƶ MedicalToday
A photo of Buffalo Bills safety DAMAR HAMLIN (3) exiting the tunnel prior to kickoff

NFL safety Damar Hamlin, who collapsed on the field during a Monday Night Football game this week, is improving and "appears to be neurologically intact," according to a .

Reports have also surfaced that Hamlin is "awake." His agent, Rob Butler, that Hamlin is awake and has been holding hands with family in the hospital, and Buffalo Bills teammate that Hamlin is awake and showing signs of improvement.

Two physicians from the University of Cincinnati (UC Health) involved in Hamlin's care confirmed during a Thursday afternoon press briefing that Hamlin indeed was "awake" and that his neurological function appeared to be intact.

Timothy Pritts, MD, PhD, chief of surgery at UC Health, told reporters that on Wednesday evening, Hamlin was able to wake up and follow commands, respond to questions in writing or by shaking his head 'yes' or 'no,' and move his hands and feet.

"The first question that he wrote when he started to awaken was, 'Did we win?'" Pritts said. "So we know that ... it's not only that the lights are on, we know that he's home. And it appears that all the cylinders are firing within his brain."

Nonetheless, Hamlin remains in critical condition and is being managed within the surgical and trauma ICU at the University of Cincinnati Medical Center.

"He still has significant progress that he needs to make, but this marks a really good turning point in his care," Pritts said.

Hamlin remains on a ventilator, though his doctors said they are trying to decrease the amount of ventilator support. Pritts confirmed that Hamlin suffered acute respiratory distress syndrome (ARDS), which prompted clinicians to place him in the prone position.

As to the cause of Hamlin's cardiac arrest, UC Health emergency physician William Knight IV, MD, said that "we do not have definitive answers to the etiology of the arrest at this time," but that tests were ongoing.

He noted that commotio cordis -- a condition where cardiac arrest occurs after a blunt force trauma to the chest at a specific time during the heart's beating cycle -- is a "rare event and a diagnosis of exclusion, so we have many other things to rule out before that can be settled on."

While the immediate moments after Hamlin fell to the ground during Monday night's game are under review, Knight gave a brief overview of the timeline.

After Hamlin was hit and fell to the ground, he initially had a pulse, which he then lost, Knight said. When no pulse was detected, responders started CPR, followed by defibrillation "within several minutes," Knight said.

Hamlin was then moved to an ambulance, where he was intubated for respiratory support, and arrived at the hospital within 30 to 45 minutes of when he went down, Knight said.

Knight called this "textbook for the type of arrhythmia that he had."

That quick response was "the reason we're talking about the recovery of his neurologic function," Pritts said.

Knight confirmed that Hamlin was only defibrillated on the field once, and that he did not receive a second defibrillation or CPR in the ambulance or at the hospital.

At the hospital, doctors used hypothermia on Hamlin, which is part of their target temperature management protocol.

Neither Knight nor Pritts would provide additional details about Hamlin's heart function or respiratory function, or whether he sustained any damage to other organs.

Knight confirmed there was "no physical or radiographic signs of head trauma," but since concussion is a clinical diagnosis, doctors have not been properly able to evaluate for it since Hamlin has been "intubated and largely sedated throughout his course."

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    Kristina Fiore leads MedPage’s enterprise & investigative reporting team. She’s been a medical journalist for more than a decade and her work has been recognized by Barlett & Steele, AHCJ, SABEW, and others. Send story tips to k.fiore@medpagetoday.com.