How Texans, NFL handle medical emergencies and how Damar Hamlin raised awareness: ‘We always have to be prepared’

HOUSTON – As Texans director of sports medicine and head athletic trainer Roland Ramirez pumped his interlocked hands to apply CPR techniques, the communication and teamwork were constant as each second was crucial during this advanced medical exercise at NRG Stadium.

“Six minutes until the ambulance gets here.”

“Thirty more seconds.”

“Clear.”

“The paramedics are here. They’re coming down the hallway now.”

During the Texans’ medical emergency preparedness rehearsal Thursday, Ramirez and other team medical personnel went through a simulation of how they would handle a serious medical situation such as a cardiac arrest, stroke, seizure or a catastrophic neck or spine injury.

That included administering oxygen to a medical mannequin and going through the protocols for automated external defibrillation. Eventually, the dummy was transported onto a board and a medical gurney and wheeled out of the Texans’ weight room.

The Texans went through multiple different scenarios under NFL mandatory guidelines. The Texans have been preparing for any medical scenario for years since 2009. On Nov. 4, 2013, former Texans coach Gary Kubiak suffered a transient ischemic attack, often referred to as a mini-stroke, during a game against the Indianapolis Colts in Houston that caused him to be immediately hospitalized as he received fast treatment from the Texans’ medical team.

“In a nutshell, we have to be prepared for any and every situation, whether it’s a laceration or cardiac event or anything in between,” Ramirez said. “We always have to be prepared no matter what the situation and making sure we’re following our protocol, our steps to make sure that we’re handling everything we can control in those situations and get the proper care as fast as possible.

“Medicine is always evolving in all sorts of different areas including instruments and devices. We have to be up to date and we know what we do in those situations and make sure we evolve with medicine.

When Buffalo Bills safety Damar Hamlin collapsed on the field on Jan. 2, 2023 after making a tackle on Cincinnati Bengals wide receiver Tee Higgins, team trainers and paramedics quickly reacted. First responders initiated CPR, automated external defibrillation, oxygen and gave him an intravenous solution. They saved his life, reviving him on the field during a Monday night game before a national television audience. “Pray for Damar” trended on social media. Hamlin has since resumed his football career with the Bills.

“It just stresses the importance of this practice of us going through these scenarios,” Ramirez said. “Like you said, we’ve been doing them for years. The fact that it happened on national television it just reinforces how important CPR is how important it is to make sure we’re practicing this you can never practice this enough, but it definitely was a big moment. I’m glad Damar had the success he had and that’s just been instrumental and proactive to make sure we are prepared.”

During the rehearsal, which included Texans executive director of player health Geoff Kaplan, Dr. Toby Thomas, the team’s emergency medicine physician and Mike Cendoma, the owner, CEO and director of operations of Sports Medicine Concepts, Inc., and various trainers and medical professionals from the team, it was evident just how much planning goes into these type of situations.

“You have to prepare for worst-case scenarios,” Kaplan said. “You have to practice certain situations, you have to practice doing different things in different climates, in different surfaces and our goal every year is to practice as many scenarios as possible and to train as much as possible so in the event that something catastrophic happens, we are prepared and we can execute the plan.”

When Hamlin had his medical episode, it was an eye-opening moment of how serious a situation can become and how prepared NFL teams need to be to handle any situation to protect life and health.

“I think the Damar Hamlin situation just brought into light how important our practicing scenarios are,” Kaplan said. “We’ve been practicing this for years. The NFL has mandated this for years that we practice it. The Houston Texans have been doing this every year since 2009, so we’ve been practicing these scenarios for a long time.

“When something happens to a fellow NFL player, I think it brings to light how important it is to train, how important it is to prepare that these situations are going to come up. We don’t know when they’re going to come up, but they are going to come up and we have to be prepared to take care of players, coaches, staff, anyone on the field at any time.”

That means practicing CPR and other advanced life-saving techniques that can happen on the field.

‘I think the most important thing when you have difficult moments is you realize and appreciate how important training is, how important education, how important keeping up with advanced life-saving technology is,” Kaplan said. “Medicine is constantly changing. Emergency medicine is changing constantly all the time. It’s important you look at policies and procedures and have an mergency action plan and practice accordingly and train.”

Aaron Wilson is a Texans and NFL reporter for KPRC 2 and click2houston.com