Online Emotion Trumped CPR Education After Damar Hamlin’s Cardiac Arrest

When Buffalo Bills safety Damar Hamlin collapsed from sudden cardiac arrest during a nationally televised Monday Night Football game on January 2, 2023, an overwhelming number of tweets over the ensuing hours were about prayer.

Now, researchers who have studied those reactions say they reflect a missed chance to elevate the conversation about the importance of bystander CPR and automated external defibrillators (AEDs).

“When broadcasting a sudden cardiac arrest event on television, the broadcasters should always include content such as a short video provided by the [American Heart Association] demonstrating the performance of CPR,” said Nino Fijačko, MSc (University of Maribor, Slovenia), who led the analysis of the emotions people expressed online in the hours and days after the incident. “It is often the case that broadcasters do not take advantage of these opportunities. Also, public awareness campaigns during sports events can influence laypeople's willingness to act when sudden cardiac arrest occurs and encourage them to seek the basic life-support training.”

In an email, Fijačko told TCTMD that understanding how people react to disturbing live events like what happened to Hamlin can help in public health efforts to redirect the conversation away from emotion and toward education. He noted that Hamlin himself has used the aftermath of the event to work with education campaigns like the #3forHeart CPR challenge in conjunction with the AHA.

“I like the idea that Mr. Hamlin is demonstrating how to perform CPR and that the video will be shown on the jumbotron at every game of the Buffalo Bills,” he added.

Messaging and Misinformation

For the analysis, published as a research letter in JAMA Network Open, Fijačko and colleagues looked at more than 83,000 Twitter posts that occurred within 24 hours of Hamlin’s cardiac arrest, evaluating changes in posts and wording over the next 24 hours.

In the first 24 hours, the most frequently expressed sentiment was anticipation, as expressed by the most posted word being “pray.” Other commonly expressed emotions were hope, fear, and sadness. While 1% of all posts included hashtags like #CPR, #AED, or #SuddenCardiacArrest, this dropped to 0.6% by the next day.

“The low frequency of these terms in public discourse may be related to the low national awareness of CPR and low prevalence of CPR training in the US, documented in prior work,” Fijačko and colleagues write.

In an accompanying editorial, Shikha Jain, MD (University of Illinois Cancer Center, Chicago), notes that while medical school training hasn’t generally included education on public health messaging around social media, “the need to provide education on incorporating these types of skills into healthcare workers’ toolbelts cannot be emphasized enough.”

One practical reason for that, Jain says, is that some used the Hamlin incident to spread misinformation online, including a fabricated national news headline implying the cardiac arrest was due to a COVID-19 vaccine injury.

However, Jain also notes that studying social media posts may not fully capture the national discourse that occurred around Hamlin, adding that the American Heart Association reported a 620% increase in page views on hands-only CPR as well as “a national increase in the dialogue surrounding cardiac arrest and resuscitation, as can be seen by data reported by National Public Radio and the American Heart Association.”