TV Myth: Shocking A Flatline Heart Rhythm Will Revive Patient

 

Defibs Dont Shock Flatlines

TV medical shows paint a dramatic scene of a life-saving moment when doctors bring a patient back from the brink using a defibrillator to shock the heart.

Everyone knows the scene when you hear the monitor “Beep… Beep… Beep… Beeeeeeeeeeeee..…..…Clear!!!…… Beep… Beep… Beep… Beep…

These shows have taught us that when a person’s heart stops completely, doctors rush to grab the paddles and shock the person, immediately restarting their heart again.

In reality – this is WRONG and does not happen!!

Defibrillators are designed to produce an electrical shock to disrupt certain chaotic and disorganized heart arrhythmias such as: Ventricular Tachycardia and Ventricular Fibrillation (defibrillate = disrupt fibrillation—see?). These two are known as “shockable rhythms”.

Ventricular Fibrillation (VF or V-Fib): This is when the ventricles of the heart are thrown completely out of synchronization and instead of pumping, they begin quivering erratically, which does not allow the heart to adequately contract to get the blood out to the rest of the body. It looks like this:

Ventricular Fibrillation ECG
Ventricular Fibrillation ECG

Pulseless Ventricular Tachycardia (VT or V-Tach): This is when the ventricles (main pumping chambers of the heart) contract so fast that they do not have time to fill and release, preventing blood from circulating to the body. It looks like this:

Ventricular Tachycardia ECG
Ventricular Tachycardia ECG

By sending a shock to disrupt the disorganized electrical activity, defibrillation momentarily stops the heart, allowing it to reset and the natural pace making function to hopefully resume a normal heart rhythm.  Think of Defibrillation as the CTRL+ALT+Delete function when the heart goes haywire.

What Does Happen When The Heart Stops?
Unlike jump-starting a car’s dead battery, defibrillators will not jumpstart the heart. The extended flatline (asystole) means that there is no electrical pattern to disrupt at all.

Asystole ECG
Asystole ECG

When a person’s heart stops in a hospital and goes into the long beeeeeeeeeeeep noise, doctors will be rushing chaotically, but instead of grabbing paddles—they will be switching off chest compressions (CPR) to keep blood flowing to vital organs and trying to quickly solve the underlying problem of why the heart has stopped.

Beyond that, medical professionals must administer drugs into the patient’s circulation to stimulate the electrical activity of the heart to start up again. If doctors can’t get the heart to restart in a reasonable amount of time, the patient will likely suffer so much brain damage that it’s more reasonable to stop efforts and let them go.

Written by: Ashley Fidler

Sources:
http://www.acls.net/aclsalg.htm
http://content.onlinejacc.org/cgi/content-nw/full/43/10/1765/FIG1
http://calsprogram.org/manual/volume3/section12/CV/08-CV7AsystoleTreatment13.html

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