Pulseless electrical activity on ecg1/15/2024 Click here to see the other myths we’ve busted over the past two years.Cardiac arrests that occur outside the hospital are one of the leading cause of sudden deaths in the USA and Canada. This is the 100th medical myth and the last in the series. So next time you see that ominous flat line appearing on the monitor, and hear the heroic physician shout “clear” while busting out the paddles, you can join the exasperated ranks of those in the know, and try not to let reality ruin this most dramatic of TV tropes for you. (I’m also ignoring the fact that adrenaline would be useless for a heroin overdose.) In fact, if you stop CPR to give an inappropriate shock, the patient’s outlook is even more dire.īut unlike the famous overdose scene in Pulp Fiction might suggest, there seems to be no survival advantage and quite considerable extra risk of giving it directly into the heart. The treatment of choice for asystole is to continue ((CPR) (cardiopulmonary resuscitation) and give a whacking great dose of adrenaline. If you’ve flatlined, a shock is the last thing you need. The causes are hard to reverse and survival rates are very low. These rhythms indicate that the heart muscle itself is dysfunctional it has stopped listening to the orders to contract. Pulseless electrical activity and asystole or flatlining (3 and 4), in contrast, are non-shockable, so they don’t respond to defibrillation. A single shock will cause nearly half of cases to revert to a more normal rhythm with restoration of circulation if given within a few minutes of onset. Hitting the heart muscle with a big dose of electrical energy acts a bit like hitting Ctrl-Alt-Delete on your computer (or Alt-Command-Esc for the Mac users). Pulseless ventricular tachycardia and ventricular fibrillation (1 and 2) are shockable, largely because they tend to be caused by the electrical activity of the heart being thrown out of whack, and not by the heart muscle itself being badly damaged. These four ECG findings are classified into “shockable” and “non-shockable” rhythms, depending on whether they respond to the electrical current of the defibrillator. Circulation therefore drops rapidly to dangerously low levels.Ī period of asystole follows some more normal beats. The heart is beating so quickly that it can’t fill properly between beats. Pulseless ventricular tachycardia (VT) is a very rapid and inefficient heart rhythm.There are four main rhythms you might see during a cardiac arrest: ![]() ![]() We can see the various electrical wave patterns of the heart in cardiac arrest using an electrocardiogram or ECG. Blood stops flowing and the body tissues have to cope with the sudden lack of oxygen supply. If the flow of this electricity becomes disorganised or the heart muscle stops responding normally, the regular pumping action is lost. The heart’s electrical system controls the organ’s ability to pump blood to the rest of the body. To understand why this myth is so egregious, we need a quick background briefing on cardiac arrest. Heck, they even named a Kevin Bacon film after it! It’s thrilling, compelling – and completely wrong. You’ve probably seen this flatlining scene a million times on TV and films.
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