Moments after Buffalo Bills safety Damar Hamlin collapsed onto the field at Paycor Stadium in Cincinnati during a regular-season football game between the Bills and Cincinnati Bengals on Jan. 2, members of the Virginia Tech Athletics Department’s sports medicine staff started exchanging text messages.

They watched in angst as a group of medical personnel huddled around Hamlin and performed CPR. Seconds later, those same medical professionals started using the automated external defibrillator (AED), two sure signs that a life-threatening event was taking place.

“You’ve got about a 5 percent chance of surviving that,” said Mike Goforth, associate athletics director of sports medicine. “But with intervention, it goes up to 60 percent, which still isn’t great. But the fact that we're having this conversation with Damar still alive is incredible and a testimony.”

Hamlin spent a week at the University of Cincinnati Medical Center before being transferred to a hospital in Buffalo. Nine days after suffering his cardiac arrest, he received his discharge and went home, where his family continues to care for him. He lives today only because of the thorough training and quick actions of the Bills athletic training staff.

The Bills organization recognized that staff before the regular-season finale against New England on Jan. 8. Denny Kellington, an assistant athletic trainer, has been singled out for administering CPR to Hamlin and saving his life, though a team of medical professionals teamed to put Hamlin on the road to recovery.

Not all the heroes wear jerseys and helmets. In this case, they stood on the sideline in team apparel, ready and willing to save a life.

Importance of athletic training

Hamlin’s cardiac arrest placed a spotlight on the profession of athletic training and its importance. Many in the public view athletic trainers as those who tape ankles and bandage cuts and scrapes during practices and competitions. Yet that represents only a fraction of what they do and what they need to know.

In the Virginia Tech Athletics Department, Goforth, along with Head Team Physician and Chief Medical Officer Mark Rogers, oversees a staff of more than 20, with at least one full-time certified athletic trainer devoted to each of the school’s varsity sports. Each trainer needs to know CPR, how to use the AED, and how to administer first aid to be certified. Their certifications are renewed annually.

In addition, they need to know everything from preseason physicals to emergency care, injury treatment and diagnosis, clinical examinations, therapeutic interventions, when and how to refer, as well as administration and professional legal responsibilities. Athletic trainers must complete an accredited curriculum and pass a national certification exam to become certified athletic trainers.

The athletics department partners with Carilion Clinic, the Via College of Osteopathic Medicine (VCOM), and local first responders. Goforth taps into these relationships often and specifically ones with the VCOM staff.

Casey Mendel, trainer resident, tennis
Casey Mendel (at right) is a full-time athletic trainer resident who works with the Virginia Tech men's and women's tennis teams. Photo courtesy of Virginia Tech Athletics.

“We have things throughout the semester and throughout the year that we do with our VCOM physicians,” Goforth said. “We practice taking off equipment, practice airway management, practice spine boarding … things like that. We make a commitment to provide the best care possible, and training, practicing is a part of that.”

Training is paramount when a medical crisis arises. In April 2010, Allan Chaney, a Virginia Tech men’s basketball player, went into cardiac arrest during an individual workout. The women’s basketball athletic trainer at the time, Amy Kunigonis, used the AED to shock Chaney’s heart back into rhythm.

Her quick actions more than likely saved Chaney’s life.

Importance of emergency action plans

Athletic trainers in the Virginia Tech Athletics Department also oversee the department’s emergency action plans if a student-athlete suffers an injury that requires a hospital visit. These plans exist for each of the athletics department’s venues – game venues, practice facilities, weight rooms, meeting rooms, and the Student-Athlete Performance Center.

The plans are thorough and include input from people with the Virginia Tech Rescue Squad, Virginia Tech police, Blacksburg police, and Blacksburg Rescue Squad, along with those from Rhino Sports and Entertainment Services, which manages game day events for the department. These plans include information such as where the ambulance parks during games, who travels with the student-athlete to the hospital, who notifies the parents, and who takes the parents to the hospital.

For practices, athletic trainers must know exactly where an ambulance can enter onto the field or park at an indoor practice facility, such as the Beamer-Lawson Indoor Practice Facility or the James C. Weaver Baseball Center.

“I think a lot of people think when the athletic trainer goes out to practice, we're just thinking about ankles and knees, but we're always surveying to see ‘OK, is there a truck blocking this gate?’” said Brett Griesemer ’12, the head football athletic trainer. “You might not notice it, but we're all looking around. Is there construction happening on the dining hall upstairs? How does that affect our emergency action plan? Is there construction at the new baseball field? Where can the ambulance get in? Where can they access?

“That's something that that we think about constantly when we go out to practice or a game. That's something that we're constantly discussing. If this happens, what's going to be our plan?”

The sports medicine staff has put its emergency action plans to use several times over the years. For example, in 2012, safety Michael Cole injured his neck in a football game against Florida State at Lane Stadium.

Goforth and his staff put Cole on a spine board, brought the ambulance onto the field, and took him to LewisGale Hospital Montgomery for treatment. Doctors diagnosed Cole with a neck sprain that ultimately led to him giving up the sport.

“We actually had an after-action meeting at the hospital with our staff, EMS, radiology, and everybody involved,” Goforth said. “We wanted to go over what we could do better.”

Hisham Ziyout, men's basketball trainer
Hisham Ziyout ’19 (at right) is the head athletic trainer for the Virginia Tech men's basketball team and is seen here with David Jackson, assistant athletics director of strength and conditioning for the men's basketball team, checking on Hunter Cattoor, who was injured in a recent game at Clemson. Photo courtesy of Virginia Tech Athletics.

Learning is a constant in athletic training. Goforth even asks the athletics department’s video staff to film his staff any time an injury occurs. Most video staffs stop filming during an injury timeout, but Goforth sees this as an educational opportunity.

“It’s a great training tool for us,” he said.

Virginia Tech students providing an assist

The training sessions throughout the year, the enacting of emergency action plans, and the filming sessions during injury timeouts serve as educational opportunities for the more than 80 students who volunteer in the sports medicine office each year.

Students aid the full-time athletic trainers for each varsity sport. They vary between part and full time, but all are required to be certified in CPR and first aid.

The work isn’t easy. During the COVID-19 pandemic, for example, several groups of students reported to work at 4:30 in the morning to help set up for COVID testing of student-athletes.

“Our students are paying to come to school here and work for us,” Goforth said. “They don't get paid, and they were up there with Brett [Griesemer] at 4:30 in the morning, setting up the stuff for COVID testing. It was amazing to see those students roll their sleeves up and get to work. It was really inspiring to see them do that.

“We couldn’t do it without them.”

Many of the undergraduate students come from the university’s Department of Human Nutrition, Foods, and Exercise within the College of Agriculture and Life Sciences and plan to pursue careers in areas like athletic training, physical therapy, occupational therapy, dietetics, pharmacy, and others.

Graduate students also work in the sports medicine office. Some earned their undergraduate degrees from Virginia Tech, but other, such as Miguel Silva, from another school. Silva, an Oswego, Illinois, native, graduated from Northern Illinois University in 2021 and is pursuing a master’s degree in instructional technology from Virginia Tech.

Silva came to Virginia Tech wanting to be an athletic trainer with an NFL or a Division I football team, and early October, his career dream came true. The New York Jets hired Silva to a position, and he starts following his graduation.

His Virginia Tech experience helped him land that job.

“They really let you control your education experience here, which is awesome, because there are other places where it's very strict,” said Silva, who works with Griesemer and the football program. “Learning here has been awesome. I don’t think any of my previous classmates are working somewhere where you have everything available like here.”

Both Goforth and Griesemer worked as graduate assistants. Erin Cash ’07, ’09, the women’s basketball athletic trainer; Hisham Ziyout ’19, the men’s basketball athletic trainer; Kelsey Deshambo ’17, the volleyball athletic trainer; Kyle Staggers ’15, the baseball athletic trainer; and Emily Whitaker ’21, the softball athletic trainer, all earned graduate degrees from Virginia Tech.

Graduate assistants work in the sports medicine office to gain additional experience while pursuing that master’s degree. The experience sets them up nicely for future employment opportunities.

Elizabeth Canfield, graduate assistant trainer
Elizabeth Canfield ’22 is one of many graduate assistants who received beneficial experience while working for the Virginia Tech Athletics Department's sports medicine staff during her time at the university. Photo by Dave Knachel for Virginia Tech Athletics.

Having graduate assistants and sports medicine aides certainly fits with Virginia Tech’s institutional philosophy that encourages experiential learning. Both sides benefit – the students get real-life experiences and the athletics department gets the students’ productivity.

“If they want to be athletic trainers, it really prepares them to go into that profession,” said Renee Eaton, the undergraduate program director in the Department of Human Nutrition, Foods, and Exercise. “For students who want to do different aspects of sports medicine, I think the greatest value is the hands-on learning. … When students go out and do job shadowing, they’re not allowed to do a lot of the things that Mike and his staff allow them to do. They really can learn and practice, so there’s a significant hands-on portion that is just so valuable.”

Future of athletic training

Currently, the demand for athletic trainers outweighs the supply. In addition to working in collegiate and professional sports settings, athletic trainers are hired by high schools, clinics, and military academies.

“I see athletic training significantly growing in the non-sports domains and in the military,” Eaton said. “They’ve found that athletic trainers can help with performance, injury reduction, and lost work time. Some of the new areas for athletic trainers include private corporations, occupational health, performing arts, and public safety.”

Yet what about the supply issue? Many graduates seek careers as physical therapists or physician’s assistants because of better salaries, and in some situations, better hours.

Virginia Tech is trying to help with the supply problem, and in doing so, living up to the university’s land-grant mission. Eaton is putting together a committee of people from various colleges within the university to explore offering a master’s degree in athletic training. Adding the degree is a multistep, multiyear process that requires Board of Visitors approval, accreditation from the State Council of Higher Education for Virginia, and accreditation by The Commission on Accreditation of Athletic Training Education.

The department currently offers both master’s and doctoral degree options in human nutrition, foods, and exercise and a master’s degree in nutrition and dietetics, but no graduate degree in athletic training. The process to add athletic training as a master’s degree figures to take some time, but the demand isn’t going away.

Athletic training as a career does offer certain perks. The demand ensures job security. The profession can provide the welcoming feeling of helping others. Those who work in sports get to enjoy high-adrenaline environments. And no day is ever routine.

One may even get to be a hero, though as the Damar Hamlin incident showed, one in this profession needs to be ready when that opportunity presents itself.

“We're very thankful something like that has never happened to us,” Goforth said. “We pray it doesn't happen to us — and we pray that we'll be ready for if it does.”

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