COLUMBUS, Ohio (WCMH) — Buffalo Bills safety Damar Hamlin returns to Cincinnati Sunday night ten months after he nearly lost his life on the football field. Hamlin fell to the ground motionless after tackling Cincinnati wide receiver Tee Higgins and taking a helmet straight to the chest.

“Brain damage starts at six minutes of no blood flow, and by eight to ten minutes, it’s completely, you’ll have suffered irreparable brain damage,” Ohio State University Wexner Medical Center Division Director of Cardiac Surgery Dr. Nahush Mokadam said.

Mokadam said it’s not a stretch to say Hamlin died on the field when his heart stopped. He said he believes it was a hit to the chest at the exact perfect timing that scrambled the electrical pulses of the heart.

Mokadam credits the emergency response team for their quick diagnosis and treatment on the field.

“Most people on a football field would think that he had a head injury, he’s concussed, he passed out, something like that. It’s to their credit that he’s here because they recognized it. They started CPR. They got an IED, and if they hadn’t done that in rapid fashion, then we would be having a different conversation,” he said.

One thing every athlete worries about after suffering any type of injury is the risk of re-injury. Mokadam said with a heart injury like this, it’s a tough question.

“That’s hard to say, and I think the answer is no. And I say that because the reason the heart’s electrical system got scrambled the way it got scrambled is, it’s incredible timing. Football players get hit in the chest all the time and this doesn’t happen all the time. I don’t think it’s going to happen again. I don’t think he’s at risk for it happening again, and I don’t think he would’ve been cleared to play if there was some finding that somebody would say you know he is at risk for this happening again,” he said.

Hamlin’s recovery has been well-documented since the injury.

“How likely is it that he comes back? Again, you know, it speaks to his physical fitness, his youth, his dedication, his work ethic, his desire to come back. I could imagine somebody might get spooked and not want to do this ever again,” Mokadam said.  

The injury has scared others, too. The safety of the game of football, especially for kids and teenagers, has been studied extensively. Mokadam said it’s something to consider as well.

“I’m a parent, too, and I had to have this conversation with my kids,” he said. “So, I don’t want to color too many people’s thoughts by my answer. Contact sports have risks, including this. And every one of those risks, maybe on aggregate, is low unless it happens to you. There’s a risk of injuries to bones. There’s a risk of injury to the brain. There’s a risk of injury to the spine and the neck. There’s risk of injury to the heart as we’ve seen here. And so, contact sports are risky and you have to make that decision as a family and decide what’s right.”

Mokadam said the most important aspect of treatment when it comes to a cardiac event is timing. With only minutes until the brain suffers permanent damage, getting blood flow to the rest of the body and brain is critical. That’s why he recommends everyone learn CPR to be able to potentially save a life by forcing the heart to pump blood to the brain until an emergency response can arrive.