Athletics experts in Manitoba say emergency plans, first aid training are key following NFL player's collapse

An extremely rare but serious medical incident during a National Football League game left many in disbelief,but in Manitoba, sports teams already have plans in place to respond to cardiac incidents during games.

Buffalo Bills defensive back Damar Hamlin remainsin critical condition after the teamsays he suffered a cardiac arrest on the field after making a tackle during the first quarter ofMonday's gameagainst the Cincinnati Bengals.

The 24-year-old tackled Bengals wide receiver Tee Higgins, got up and collapsed backwardonto the turf at Paul Brown Stadium in Cincinnati.

Emergency medical personnel responded, including administering CPR and using a defibrillator to restart his heart.

The game was suspended until further notice, and the league hasn'tmade a decision on the potential resumption of the week 17 matchup.

Jeff Billeck, the head athletic therapist withthe University of Winnipeg Wesmen,works with the school's varsity athletes to provide on-field clinical care and return-to-play situations.

Billeckwasn't watching the Bills-Bengals game live, but said Tuesdaythat what happened to Hamlin was a "very difficult situation."

Prior to any game involving any of the Wesmen's athletic teams, Billeck says he and his team create an emergency access plan, which involves a primary person with first-responder training, an assistantand someone to call.

"In our case, all athletic therapists and all athletic therapy students ...go through first-responder training," he said. "That's where we'd go through all the skills to deal with a situation like that."

Billeck believes certified athletic therapists atthe professional level, such as those with the Winnipeg Blue Bombers and Winnipeg Jets, are very prepared to handlesituations like what happened to Hamlin.

'We felt helpless'

Although rare, Billeck said cardiac events can occur more often than what millions of TV viewers saw on Monday Night Football.

Ryan Bliznikaswasn't tuned into the Bills-Bengals game either, but heknows all about the angst of watching someone go through a cardiac arrest.

Bliznikas, the vice-president of Football Manitoba, was playinga pick-up game of floor hockey with about a dozen guys in Thunder Bay, Ont., 10 years ago when one of them collapsed, and later died.

"At that point in time we felt helpless. You wanted to be able to do something, and even though the ambulance should have been around the corner from where we were," he recalled Tuesday.

He doesn't know how long they waited for the ambulance, "butthose minutes feel like hours when you're in a situation like that."

That tragic incident prompted Bliznikas and the other members of their floor hockey group to seek out first aid training. They took a St. John Ambulance course three weeks later.

"You felt like you were there for a purpose," he said of the first aid training.

Bliznikas is hoping for the best for Hamlin, but said scary incidents like arrhythmia can happen randomly.

"It just goes to show that that can happen to anyone in any situation, no matter if it's shovelling snow, doing something for fun, like a rec league thing with a couple of buddies, or being a highly-trained athlete," he said.

He says all Football Manitoba gameshave certified physical therapists on the sidelines at all games.

AEDs mandated throughout Manitoba

In 2012, Manitoba became the first province to have legislation in place for defibrillators.

The Defibrillator Public Access Act was later introduced by the former NDP government, requiring certain public spaces to have defibrillators installed by Jan. 31, 2014.

Schools in the province, indoor arenas, fitness facilities, community centres and airport terminals are among the public spaces mandated to have defibrillators.

Automated external defibrillators (AEDs)are electronic medical devices used to reset irregular heart rhythm, and they aresupposed to be checked monthly in Canada.

Christian Clavelle, the president of Canadian First-Aid Training in Winnipeg, says use of a defibrillator is a "definitive reason" whethersomeoneexperiencing cardiac arrestwill survive or not.

"CPR, combined with the AED, is going to significantly increase the chance of survival," he said.

Time is truly of the essence when someone requires a defibrillator, according to Dr. Ali Khadem, a cardiologist and electrophysiologist at St. Boniface Hospital.

"If somebody had a cardiac arrest, and doesn't get CPR or defibrillation within five minutes the chance of surviving and leaving hospital independently is less than five per cent," Khadem said.

The province instituteda three-minute rule, meaning facilities have to install as many defibrillators as possible so they are easily accessible and ideally can be retrieved in under three minutesin case of an emergency.

"It is very important to immediately [assess] the situation to performeffective, good-quality CPR and have an automatic defibrillator in schools, universities, public areas, airports, especially in arenas ... and people need to know how to use them."