I guess I’m talking about defibrillation. Is it just the movies, or is it how defibrillation actually works in real life ?
I mean, you are trying to revive someone, trying to bring them back to life. What’s the worse thing that can happen ? Why do they start from low voltages and increase it slowly, and get more and more anxious and dramatic every time they say “Go up to 350” or whatever.
I mean, the person is already dead. What’s the risk ? Why do they act so hesitant ? What’s there to lose ?
In: Biology
The general thought is that using the lowest level of energy to convert the heart from ventricular fibrillation, ventricular tachycardia or atrial fibrillation to a normal rhythm is best. The idea is that the greater the shock, the greater the risk of creating a parasympathetic nervous system discharge that can theoretically prevent the heart from restarting.
When portraying these types of situations, TV and movies often take liberties with medical accuracy in attempt to create tension or drama. Cardioversions for certain abnormal arrhythmias are very routine procedures that aren’t particularly dramatic. Cardiac arrests however can be quite dramatic, extremely emotional events when we are working hard to save someone’s life. Factor in things like a patient’s youth, an unexpected negative event, or an emotional connection you have with the patient or their family and the adrenaline gets pumping rapidly. So yeah- we will not hesitate to escalate the shock energy when indicated and tv doesn’t always show things the way they happen in real life.
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