time for a defibrillator question

[Alpo]

On all the medical shows where they zap somebody to get their heart working correctly again, they have the paddles, they're over the body, CLEAR!!, the paddles are touched to the body, THUNK, they are immediately lifted off.

 

They might be on the patient for a half a second at most.

 

The show I am watching currently, she yelled clear, she zapped him, and then she looked over at the beep beep beep machine that was still showing flat line, and all that time the paddles were still on him.

 

So she lifts them off, yells clear again, zapps him again. And they go to another scene before we can see whether it brought him back to life, but she still has the paddles on the body.

 

Does it matter whether or not they are immediately removed? There's a push button on them, right? So you put the paddles on the body and you push the button to zap him. It's not like pushing jumper cables up there and as soon as they touch the electricity is going through him?

 

Or is it? As long as the paddles are on him he's still getting zapped?

[Major Crimes]

On the Defibs here they are stuck onto the chest and stay there until the patient is revived. 

 

The machine monitors the heart and decides when they need a zap, you get a warning its coming and then zap.

[watab kid]

interesting , never had that , but i do have a pacemaker so im probably getting it without the warning or the zap , 

[sassnetguy50]

1 hour ago, watab kid said:

interesting , never had that , but i do have a pacemaker so im probably getting it without the warning or the zap , 

Not everyone feels the pacing.  Everyone conscious knows if an ICD administers a "therapy", like being dropkicked.

[watab kid]

mine is a constant sustaining device , as long as the battery holds up im upright , its constantly monitored to an ap on my phone and transmitted to the medtronic service , i dont feel it happening , but i know it is because if it stops ill not be normal - i wont die , but ill not be able to get up and walk around normal , i have brady cardia , 

21 minutes ago, sassnetguy50 said:

Not everyone feels the pacing.  Everyone conscious knows if an ICD administers a "therapy", like being dropkicked.

 

a jolt from one of these would probably kill my pacemaker and perhaps me , 

[Dr. Zook]

The old Life-pack Defibrillator's used paddles up until give or take the LP-12 model - I used the LP-5, LP-10, LP-11, LP-12 and LP-15's in the field to either cardiovert or defibrillate a patient in the field.  On the LP-5, LP-10 which were 'paddles' only, we either used defib gel (yes, Squad 51 style Johnny and Roy) or gel sheets (like a fruit roll up thickness and about 4"x6" in size that was applied to the patient's chest prior to applying the paddles so that we got good electrical conductivity and didn't leave a burn mark from arcing (all jewelry was removed or moved out of the way prior to applying the paddles or gel/gel sheet).  Those monitors had a "quick look" function where we could 'see' an ekg rhythm without applying the 3 lead EKG wires but still had to gel up to get good conduction.  As to the "jerk" that you see when they defibrillate the pt, it is more animated on the TV shows.  Yes, when you defibrillate someone - the electrical discharge used to 'defibrillate' the heart causes a systemic muscular contraction/response throughout the body and I have seen a First responder get their 'jewels' rung by kneeling over a pt's arm, defibrillating and the pt's arm "bounced" upwards with the 'shock' delivery...

 

5 hours ago, Alpo said:

On all the medical shows where they zap somebody to get their heart working correctly again, they have the paddles, they're over the body, CLEAR!!, the paddles are touched to the body, THUNK, they are immediately lifted off.

 

They might be on the patient for a half a second at most.

 

The show I am watching currently, she yelled clear, she zapped him, and then she looked over at the beep, beep, beep machine that was still showing flat line, and all that time the paddles were still on him.  They could also have either a 3-lead or 4-lead EKG wires hooked up which will show the rhythm before and after the 'shock; is delivered. You also DONT shock "ASYSTOLE"  i.e. ----------------- or 'flatline'.

 

So, she lifts them off, yells clear again, zaps him again. And they go to another scene before we can see whether it brought him back to life, but she still has the paddles on the body. Hopefully, in the show they also "charge" the defibrillator each time they go to use it...

 

Does it matter whether or not they are immediately removed? There's a push button on them, right? Yes, the paddles have a discharge button to press when you "shock".

So, you put the paddles on the body and you push the button to zap him. It's not like pushing jumper cables up there and as soon as they touch the electricity is going through him? No 'shock' is delivered until you press the discharge buttons on the paddles or the 'shock' button on the cardiac monitor otherwise no electricity is flowing thru the cables.

 

Or is it? As long as the paddles are on him he's still getting zapped?  As noted above, no electricity is delivered until the discharge button on the paddles or cardiac monitor is pressed.  Same goes with Multi-function pads (defibrillation or pacing capabilities) - those sticky pads are applied to the patient's chest and stay on throughout the call. With a multi-function pad in defibrillator mode, electricity only flows when the 'shock' button is depressed. The multi-function pads in "Pacer" mode delivers a small dose of electricity at regular intervals to 'pace' the heart beat externally when the hearts pacemaker cells are unable to do that function {usually set at 70 beats per minute & a sufficient milliamp amount to ensure both electrical and mechanical capture).  If I am pacing you, then those pads stay on until we get to the ER, the ER puts their pads on & they achieve 'capture' to continue pacing you.

 

[Dr. Zook]

34 minutes ago, watab kid said:

mine is a constant sustaining device , as long as the battery holds up im upright , its constantly monitored to an ap on my phone and transmitted to the medtronic service , i dont feel it happening , but i know it is because if it stops ill not be normal - i wont die , but ill not be able to get up and walk around normal , i have brady cardia , 

 

a jolt from one of these would probably kill my pacemaker and perhaps me , 

I've defibrillated a pt with a Pacemaker/ICD (which is usually implanted Left upper chest - the defib pads usual placement is Right upper chest and Left Axial chest)--- it overrides the internal pacemaker when the shock is delivered - if it restores a 'normal' cardiac rhythm usually the pt's internal pacemaker then resumes pacing the pt - if it doesn't, then I can externally pace the pt with my cardiac monitor until we get to the ER & turn care to the MD's.  If it doesn't restore a 'normal' cardiac rhythm, then it's CPR and during pulse checks if the heart rhythm is a 'shockable' rhythm then we would perform defibrillation followed by CPR. If we don't have a 'shockable' rhythm at those pulse checks, then its CPR & drugs until we get to the ER and turn care to the MD's.

[watab kid]

6 minutes ago, Dr. Zook said:

I've defibrillated a pt with a Pacemaker/ICD (which is usually implanted Left upper chest - the defib pads usual placement is Right upper chest and Left Axial chest)--- it overrides the internal pacemaker when the shock is delivered - if it restores a 'normal' cardiac rhythm usually the pt's internal pacemaker then resumes pacing the pt - if it doesn't, then I can externally pace the pt with my cardiac monitor until we get to the ER & turn care to the MD's.  If it doesn't restore a 'normal' cardiac rhythm, then it's CPR and during pulse checks if the heart rhythm is a 'shockable' rhythm then we would perform defibrillation followed by CPR. If we don't have a 'shockable' rhythm at those pulse checks, then its CPR & drugs until we get to the ER and turn care to the MD's.

how can you restore a normal rhythm when the heart has failed - the node that drives the normal hs quit - thats what the pacemaker has replaced in me , if mine fails i already experienced what is going to happen to me , not pleasant but no pain and ill still be alive just not able to get up and walk about - function , 

that clastic -"ive fallen and i cant get up? that i used to laugh at - now i dont , 

 

if my pacemaker quits they need to change the battery at the least or replace it at worst , im going in to the clinic next week for an annual review , my phone monitors it constantly , i get a notice if its not recording , 

ill live to get to the ER without a jolt i think , my other node is working fine - the one that kicks i when you are resting or sleeping , it the one that gets me p and moving around thats failed , 

[Dr. Zook]

The heart has natural pacemaker cells - The primary site is the SA node, although cells in the atrioventricular (AV) node, bundle of HIS, and Purkinje fibers also have pacing capability. 

I should have been clearer in the explanation of 'normal' rhythm - if you have a pacemaker that treats your 'bradycardia' and your heart went into a 'lethal rhythm' - V-fib/V-tach w/o pulse for example and you had to be defibrillated.  If that 'defibrillation' restored a 'normal' rhythm in your case 'brady cardia' - the implanted pacemaker would then continue pacing the heart as it was originally intended to.

[Hardpan Curmudgeon SASS #8967]

So... what's the faulty "bio-pacemaker" part that causes AFib?  

 

I ain't askin' for a friend.  

 

(Might consider changin' my alias to "The Metoprolol Kid")  

[Dr. Zook]

that is a question for the folk's in the white lab coats----  😁

5 minutes ago, Hardpan Curmudgeon SASS #8967 said:

So... what's the faulty "bio-pacemaker" part that causes AFib?  

 

I ain't askin' for a friend.  

 

(Might consider changin' my alias to "The Metoprolol Kid")  

 

[Alpo]

1 hour ago, Dr. Zook said:

You also DONT shock "ASYSTOLE"  i.e. ----------------- or 'flatline'.

The show - Lucifer. The plot of the show - Lucifer got tired of hell so he moved to Los Angeles. And to make sure he never went back he cut his wings off. So now he can't fly back to hell.

 

And there was a doctor who was poisoning people. And he was using designer poisons, which had designer antidotes. The cop was about to arrest the doctor and the doctor pulls out of knife and cuts his own throat. So he's dead and has gone to hell because he was an evil murdering bastage.

 

But he also stabbed the cop with the poison needle. And since he's the only one that knows the antidote, the cop is going to die.

 

So Lucifer decides that he will go back to hell, find the doctor, get me antidote, and then come back to earth.

 

So they zap him and stop his heart. He's dead. When he has the information this needed they zap him again and restart him. But he was graveyard dead, flatlined.

 

Don't you just love television. 😁

[WD Farren]

I am shocked by all the great answers!

[Chickasaw Bill SASS #70001]

SHOCKING , ain't it