When will Damar Hamlin wake up? Will he play in the NFL again? trends now
NFL star Damar Hamlin is still in critical condition in hospital and is yet to regain consciousness after his on-field cardiac arrest left the nation in shock.
Doctors believe the 24-year-old suffered a freak injury where the heart struck at a precise angle and time in the pumping process that prevents it from getting blood around the body.
They say he has already cleared the first major hurdle — surviving. Only 3 percent of sufferers survive if CPR is not administered within three minutes of the injury.
Medics rushed onto the field and gave Hamlin treatment immediately on Monday night after the Buffalo Bills safety tackled Cincinnati Bengals receiver Tee Higgins.
But now questions have been raised about when he will wake up, when medics will know what really happened and if he will play in the NFL again.
The Buffalo Bills safety, who has set up charity toy drives to raise money for his local community, had tackled Bengals receiver Tee Higgins in the first quarter of the pivotal Monday night game
The rare injury occurs when something makes contact with the chest wall precisely when the heart's lower chambers start to refill with blood. The impact then causes a rapid and disorganized contraction of the heart's lower chambers, preventing the heart from getting blood to the rest of the body. The window for this to happen is just 20 milliseconds, making commotio cordis incredibly rare. Just 30 people a year suffer the injury worldwide and only around 200 cases have been reported among Americans. It has previously been noted in young baseball or hockey players who receive a blow from a baseball or hockey puck to the center of their chests
When will he wake up?
Hamlin is currently heavily sedated on medication in hospital, meaning he is not conscious or able to respond to medics.
There are three main levels of sedation: A heavy load puts - and keeps - patients asleep, a moderate level leaves them drowsy and they may fall asleep, and a minimal load makes them feel relaxed while still awake.
Dr Deepak Bhatt, a top cardiologist at Mount Sinai Heart in New York City, told DailyMail.com: 'They will lighten the sedation either today or tomorrow, if they haven't done it already.'
Dr Mariell Jessup, the chief medical officer at the American Heart Association, added: 'They are [likely] easing back on sedation, to have someone more awake, more responsive, and able to breathe on their own again.'
Will he make a full recovery?
Dr Bhatt said based on available information he expected Hamlin to make a 'pretty substantial if not full recovery'.
He told DailyMail.com: 'Restoring the heartbeat on the field is an excellent sign. If CPR was started properly, then I would expect a full recovery of brain function.
'At ICU there is always the risk of other complications coming up.
'There's always a risk of getting infections, pneumonias, and other conditions that doctors must be vigilant for.
'But in a young person, I would not expect this complication I mention.'
Dr Deepak Bhatt, a top cardiologist at Mount Sinai Health in New York City, said what was available publicly suggested that the player could make a substantial if not full recovery. Dr Mariell Jessup, the chief medical officer at the American Heart Association, also gave an assessment of the player's condition
He added: 'When people are in ICU as we say in the US, they are not out of the woods yet.
'But the limited news we have is very, very positive.'
Will he play again?
If doctors find that Hamlin has an undetected heart issue, he might not be able to pass the medical examination required to play in the NFL.
But if it turns out to be commotio cordis and he makes a full recovery, doctors see no reason he cannot play in future.
The rare condition - which has only been recorded in around 200 Americans - does not necessarily leave lasting damage to the heart.
This is because it's an injury that is more about precision and timing than the force of impact.
It occurs as blood is released into the lower chambers for pumping during a 20-millisecond window, disrupting the mechanism that sends blood to the rest of the body.
This is when the heart stops beating altogether due to problem with the organ's electrical signals, which prevents blood from pumping around the body.
'How often does lightning strike the same place twice?' said Dr Bhatt.
But he added: 'It is very tough for whoever the treating physician is [to decide if he can play again].
'There will be pressure from the player and his team, but if something bad happens everyone will turn to the doctor and say 'what were you thinking?'.'
He said the decision will likely be made based on the heart problem and whether testing picks up any other underlying conditions.
Dr Bhatt added there would still be questions about whether Hamlin can play again even if it is determined to be commotio cordis because it's so rare.
'There is very little good data on this,' he said, 'which leaves doctors struggling to work out whether it could happen again.'
Hamlin's collapse has echoes of the injury suffered by Danish soccer player Christian Eriksen at the Euro 2020 competition.
The player suddenly collapsed on the pitch when he went to kick the football and was rushed to hospital, where doctors diagnosed him with a cardiac arrest.
This is when the heart stops beating altogether due to problems with the organ's electrical signals, which prevents blood from pumping around the body.
It is still unclear exactly what happened to Eriksen, but the player was fitted with an Implantable Cardioverter Defibrillator (ICD) device — which can reset the heart after a cardiac arrest.
He eventually had to leave his team Inter Milan, but was able to return to the pitch eight months after the injury — playing first for Brentford and then Manchester United.
Why is he on a ventilator?
Some people stay unconscious after having a cardiac arrest, and need intubation and ventilation with a breathing machine to keep their lungs working.
The medical staff will try to find out the cause of the cardiac arrest during this time, and provide any necessary treatment.
Hamlin, pictured in October, managed to get up briefly before falling backwards to the ground and laying motionless as an outpouring of support flooded in for the young player
These include chest x-rays and blood tests. Hamlin will also be monitored using an arterial line, oxygen saturation monitor and bedside monitor.
Dr Bhatt said: 'After a cardiac arrest patients are usually put on a ventilator.
'You start off at 100 percent
