defibrillator question

[Alpo]

I understand that if the heart is not beating correctly or has possibly stopped entirely you zap it to either get it going again, or to get it going correctly.

 

But if your heart is working correctly and somebody zapped you, what would be the result?

 

Would it stop your heart? Make it start being crazily?

 

TV show, and they zapped the bad guy. He just looked kind of stunned and then fell down. I'm sure that he would get up and be fine later, because these are good guys that don't kill people. But that's the TV show.

 

But it made me wonder what would happen in reality?

[J-BAR #18287]

The heart normally contracts (beats) when the heart muscle gets a signal (depolarization) from the pacemaker, a region of heart tissue in right atrium, that spontaneously depolarizes at an average of 72 times per minute.

 

Atrial fibrillation occurs when there are other places in the atria that signal the heart to beat faster than the normal pacemaker.  Ventricular fibrillation, much more dangerous, occurs when oxygen-starved ventricles begin contracting without waiting for the normal electrical signal from the atria.

 

Defibrillators depolarize ALL the heart tissue at the same time, IN THE HOPE that the normal pacemaker will resume control and the regular heartbeat will be re-established.  Sometimes it works, sometimes it doesn’t.

 

”Zapping the heart” when it is not already fibrillating can induce fibrillation, causing death.  That’s what happens when you stick something like a penny or paper clip into a wall outlet.

[Alpo]

Yeah, that's kinda what I thought.

[Alpo]

2 hours ago, J-BAR #18287 said:

Defibrillators depolarize ALL the heart tissue at the same time, IN THE HOPE that the normal pacemaker will resume control and the regular heartbeat will be re-established.  Sometimes it works, sometimes it doesn’t.

So it's not starting the heart up again, like jump starting a car (which is the impression I get from medical shows on TV).

 

It's more like giving your computer a hard reboot. It turns everything off, hoping that it starts up again on the default?

[J-BAR #18287]

Pretty much.

 

 

[Ozark Huckleberry]

Exactly what happened to a close friend.

 

Worked on a heavy extraction team with nearby county's FD. 

 

Defib training, mistakes were made -- long story short, he got hit with full-bore defib. As I understand it, he was basically dead.

 

Survived the experience, but facing other issues, including post-electric shock syndrome.

[Capt. James H. Callahan]

It would make sense that it would screw up a normal rhythm. I've worked many codes in my time in hospitals and lots of defibs. I can tell you it's not as seen on TV. When a patient is shocked they don't flop like a fish. Usually there's no visible reaction. Sometimes there's a slight "shiver" I guess you would call it. And when a code comes in the doctor is not waiting at the door to run down the hall pushing the gurney and shouting out orders.  The code team is pretty much hanging out in the ER room twiddling their thumbs waiting.

JHC

[Utah Bob #35998]

Emergency auto defibrillators like officers and paramedics carry will absolutely not administer a shock if the heart is functioning normally. As far as the paddles they use in the OR, I don't know.

[Abilene Slim SASS 81783]

Those are the kind I learned to use. They have a voice prompt on when to administer the shock. 

[Marshal Hangtree]

5 hours ago, Utah Bob #35998 said:

Emergency auto defibrillators like officers and paramedics carry will absolutely not administer a shock if the heart is functioning normally. As far as the paddles they use in the OR, I don't know.

 

Bob nailed it.

[Alpo]

Hospital ones - do they need to be plugged into a wall, or do they have a battery attached to them, so they're ready to go immediately?

 

The TV show, the cart was just sitting in the hallway.

[Cheyenne Ranger, 48747L]

we have an AED at the range.  Hope we never have to use it but it's there and we've got a number of cowfolk trained to use it.

[Ozark Huckleberry]

Auto defibrillators run a diagnostic on the heart rhythm and only shock if needed. They even warn responders to stand clear before they shock.

 

As far as being trained to use one, it's more like a remedial reading course -- every AED I've seen has pretty clear instructions.

 

But that's AEDs with leads that are stuck onto the patient. Cart-based manual defibrillators with hand-held paddles are triggered by the operator.

 

 

 

[Charlie Harley, #14153]

I used to work in a large power plant that had a robust safety program, including lots of AEDs around the plant and regular training on how to use them.

 

One Saturday a team was working a repair when a member had a heart attack and went down hard.  His buddies put the AED on him, and he recovered to where he was talking to the paramedics by the time they arrived.

 

Had James not been working the outage on a Saturday and been at home, he’d have died.

[BLACKFOOT SASS #11947]

If you just pee on an electric fence a lot of your questions will be answered!

Blackfoot

[Capt. James H. Callahan]

17 hours ago, Alpo said:

Hospital ones - do they need to be plugged into a wall, or do they have a battery attached to them, so they're ready to go immediately?

 

The TV show, the cart was just sitting in the hallway.

Crash carts don't have defibrillators, mainly meds. Pharmacy takes care of those, checking expiration dates etc. They were a PITA. Epi and Bicarb have short dates, had to swap fresh ones out a lot.

JHC

[Ramblin Gambler]

4 hours ago, Capt. James H. Callahan said:

Epi and Bicarb have short dates, had to swap fresh ones out a lot.

 

Epi as in an epi pen?  I've had mine for a few years.  How short are the dates on the ones in the hospital? 

 

 

[Cactus Jack Calder]

Alpo,

I have an Implantable Cardioverter Defibrillator (ICD). It has a pacemaker function and a defibrillator function. I’ve had one for 13+ years, it has been replaced because the internal battery ran down. The defibrillator function only fired once, when it was tested on installation. I was conscious at the time. Believe you, me, you don’t want to experience that. It feels just like J Bar said, “sticking your finger in an electric socket”. Don’t ask me how I know that.

 

What is really weird is that when the battery runs low they beep. Having your wife tell you at midnight, “You are beeping”, is kind of a strange experience. Fortunately it didn’t continue all night, but it did a repeat the next night.

When we saw the Cardiologist about having it replaced he said “Oh no rush, you have about three months of battery left.” Then as he is walking out of the examination room he says, “By the way would you like me to turn off the beep?”  I said “Nah, I want to wake my wife up every night with beeping at midnight.”

[Sedalia Dave]

9 minutes ago, Cactus Jack Calder said:

Alpo,

I have an Implantable Cardioverter Defibrillator (ICD). It has a pacemaker function and a defibrillator function. I’ve had one for 13+ years, it has been replaced because the internal battery ran down. The defibrillator function only fired once, when it was tested on installation. I was conscious at the time. Believe you, me, you don’t want to experience that. It feels just like J Bar said, “sticking your finger in an electric socket”. Don’t ask me how I know that.

 

What is really weird is that when the battery runs low they beep. Having your wife tell you at midnight, “You are beeping”, is kind of a strange experience. Fortunately it didn’t continue all night, but it did a repeat the next night.

When we saw the Cardiologist about having it replaced he said “Oh no rush, you have about three months of battery left.” Then as he is walking out of the examination room he says, “By the way would you like me to turn off the beep?”  I said “Nah, I want to wake my wife up every night with beeping at midnight.”

 

You wife is a lot more forgiving than mine. 

[Capt. James H. Callahan]

7 hours ago, Ramblin Gambler said:

 

Epi as in an epi pen?  I've had mine for a few years.  How short are the dates on the ones in the hospital? 

 

 

Same stuff, epinephrine. Epi pens have short dates too. Check it. Epi doesn't have a long shelf life. A few years is probably too long.

JHC

[Capt. James H. Callahan]

Epi Pens should have swap deal with the manufacturer. They may send you fresh ones (they're usally 2 packs). Check your box. They got STUPID expensive a few years back, have come down somewhat. Another stupid is the same company makes Epi Pens and the generic. Mylan.

JHC

[Capt. James H. Callahan]

23 hours ago, Capt. James H. Callahan said:

Crash carts don't have defibrillators, mainly meds. Pharmacy takes care of those, checking expiration dates etc. They were a PITA. Epi and Bicarb have short dates, had to swap fresh ones out a lot.

JHC

Thinking back on it, I may have been in error. Crash carts on the units may have had defibrillators. Those weren't my job, and it's been 25 years since I worked in a hospital.

JHC

[Ramblin Gambler]

13 hours ago, Capt. James H. Callahan said:

Epi Pens should have swap deal with the manufacturer. They may send you fresh ones (they're usally 2 packs). Check your box. They got STUPID expensive a few years back, have come down somewhat. Another stupid is the same company makes Epi Pens and the generic. Mylan.

JHC

 

Mine said it expires in August 2016 and I think I got it in 2015.  But it also says replace if the solution is discolored in the window and the Dr told me that's the real expiration.  It's not discolored yet. 

[Cactus Jack Calder]

An additional note on Pacemakers and ICDs. The normal procedure when installing one is to place it on the right side shoulder height in the front. If you shoot any long gun right handed ask your cardiologist to place it on your left side. I was very lucky that my Dr asked me if I shoot. When I told him I was a hunter he said “ OK, then we will place it on the left. Otherwise I might have been forced to give up hunting and never take up CAS. 
YOU HAVE BEEN WARNED!

[Capt. James H. Callahan]

20 hours ago, Ramblin Gambler said:

 

Mine said it expires in August 2016 and I think I got it in 2015.  But it also says replace if the solution is discolored in the window and the Dr told me that's the real expiration.  It's not discolored yet. 

4 years expired! I wouldn't trust it. Get a new one pard. Epi is only good for a year or so.

JHC