Tuesday, July 28, 2009


Mass Media Misdirection


When a patient passed away this morning and the cardiac monitor showed asystole (a "flat line"), a relative of the patient asked whether we could use the defibrillator pads to "revive" him.

This is no doubt the result of the mass media portrayal of dramatic medical resuscitations.. I shall give you the facts here: asystole (flatline) = NO defibrillation. This is stated clearly in Advanced Cardiac Life Support (ACLS). In fact the correct treatment is to start the CPR-Drug-CPR-Drug sequence.

Another fact: even in situations when the defibrillator can be used, it is not guaranteed that the normal heart rhythm can be restored. This depends a lot on the underlying disease/pathology, and (I hate to say this) luck. That said, even if the normal heart rhythm is restored, the consciousness/functional level may not be. So do not expect a patient to get up and walk/talk after a shock. More often than not, resuscitation of collapsed cases fail.

How many times have we guffawed/sneered at TV doctors jumping onto a patient to shock him when the monitor shows a flat-line... and even more ridiculously, the patient waking up and talking immediately..

Scriptwriters/directors of medical dramas, please get some basic facts right.

posted by nwxiang at 9:15 PM |


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