The rhythmic stomp of two dozen athletic trainers and medical personnel hustling across a turf field displaced the stark silence. A football player lay flat on the turf, motionless, his upper body obscured by the semi-circle of experts jumping to his aid. Suddenly, his once-limp legs — the only part of his body visible from the sideline — begin convulsing, spasming for a solid five seconds.

This was the scene at Ascension Saint Thomas Sports Park on Monday, inside the Tennessee Titans' practice facility just a day before the start of training camp. The injury was one of several simulations staged by the NFL and third-party service Sports Medicine Concepts to evaluate and prepare the Titans' training staff in the event of an on-field emergency medical situation such as the cardiac incident Buffalo Bills safety Damar Hamlin survived in January 2023.

In the first quarter of the game against the Cincinnati Bengals, Hamlin collapsed after making a routine tackle. He had suffered a cardiac arrest incident; CPR was administered and a defibrillator was used for nine minutes before his heartbeat was restored on the field and he could be taken to the hospital.

"If you look back to situations like the Damar Hamlin situation, in that moment those specialists are simply doing what they’ve trained on a day like today to do," said Dr. Allen Sills, the NFL's chief medical officer, who was on hand Monday. "We think this is hugely important for us for that preparation."

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How Tennessee Titans are preparing for 'Damar Hamlin situation'

NFL teams have hosted mandatory clinics such as these since Sills took over the league's health and safety office in 2017. In the situation outlined above, the Titans' staffers and third-party specialists were running through a simulation based on a concussive hit former Pittsburgh Steelers tight end Heath Miller suffered in 2010.

In another simulation earlier in the sessions, the emergency team responded to a non-contact cardiac arrest where a player passed out, was not breathing and had no pulse after reporting fatigue and loss of breath.

In the latter scenario, Dr. Brady Allen, chair of the Ascension Saint Thomas emergency medical department, was among the leaders monitoring the player's health. After it was deemed the player was unconscious, Allen called for a two-minute cycle of CPR, an IV to be placed, a health monitor to be connected for the player's vital signs, and for a defibrillator to be charged in the event it was needed. Various staffers cycled in and around Allen, including multiple athletic trainers who took turns giving chest compressions so the pace could remain steady without one trainer getting tired. Vitals such as fluid levels, oxygen saturation and blood pressure were all accounted for before Allen signaled it was time to get the player on a stretcher, then on to the medical cart to be taken off the field for further evaluation.

"The worse a situation is, the easier it is to deal with, because it’s very clear-cut what you do," said Titans director of sports medicine Todd Toriscelli, who is entering his 28th year in the NFL. "If I’m trying to decide if a guy with a strained hamstring should play or stop, that’s hard. But when something catastrophic happens, it’s A-B-C. It’s very clear-cut what we do. It’s clear-cut what the doctors do. Everybody has to know their role, not panic, and it’ll get handled the way it should."

Training such as this pays off in the most dire of situations. Toriscelli brought up the instances in 2021 and 2023, when the Titans' medical team had to respond quickly to spine-board offensive tackle Taylor Lewan and receiver Treylon Burks off the field after injuries to the head and neck areas, as moments where this kind of training turned practical.

These aren't one-time sessions, either. Toriscelli said he and his staff will have another training session at Nissan Stadium before the start of the season and hold monthly practices as refreshers. And on game days, the emergency medical personnel hold meetings with officials and specialists 60 and 90 minutes before game time, with walk-throughs on who handles what responsibilities, where the necessary equipment is and who will be coordinating which factors in the event of an emergency.

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Sills likes to joke that an NFL field is the second-safest place in America a person can collapse, trailing only the inside of a hospital. Toriscelli posits the stadium may be even safer than a hospital; no one injured in a football game has to wait in an ER or is at the mercy of the on-call physician. Players get immediate care from the most qualified doctors possible.

Which, as is often the case when talking about NFL medical responses, brings the conversation back to Hamlin.

"They did a great job with him because that could’ve been bad," Toriscelli says. "I’m just really happy that worked out the way it did. That justifies everything we’re doing here."

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Nick Suss is the Titans beat writer for The Tennessean. Contact Nick at nsuss@gannett.com. Follow Nick on X, the platform formerly called Twitter, @nicksuss.

This article originally appeared on Nashville Tennessean: Tennessee Titans prep for 'Damar Hamlin' type medical emergencies