6th May 2019 Friday Resus Ready First Aid Trivia
Should you defribrillate an asystole rhythm?
This week’s trivia question comes from the advanced life support play book but it is something that commonly appears on television show so it’s a question worth asking.
TRUE or FALSE:
Using a manual defibrillator you SHOULD defibrillate a “flat line” or asystole heart rhythm because it is a shockable rhythm.
Option 1: True, you should shock
Option 2: False, you shouldn’t shock
Results from the facebook poll are:
- Option 1 – TRUE you should shock 19% 19%
- Option 2 – FALSE you shouldn’t shock 81% 81%
How many times have you seen on a medical television show the main character approaching the deteriorating patient calling out “QUICK HE’S FLAT LINING, CHARGE TO 180, SHOCK! GIVE ME 300, SHOCK!!” Firstly, the term “flat lining” is never used in the medical setting, secondly we don’t shock asystole, thirdly he has used two different types of shock levels for different types of defibs (something we won’t get into today, but if you’ve ever sat next to me during a medical show you know how much this annoys me). So if you answered Option 2 – False you shouldn’t shock then you would be correct!!
To clarify this is for a MANUAL defibrillator used by a trained professional (doctors, nurses and paramedics). Using a manual defibrillator, the professional has the ability to dial up the appropriate Joules of energy. The trained professional then assesses the casualties heart rhythm and determines if it is shockable or non-shockable. The professional then either delivers the shock or disarms the shock based on the heart rhythm.
An Automatic External Defibrillator (AED) used by first aiders in the community has all of this inbuilt into the programing. So as a first aid responder you wouldn’t be required to analyse a rhythm because our handy AED would be doing that for us and would only give us the option to shock if it was safe to do so.
So back to the question, do you shock an asystole heart rhythm? To answer this, lets first look at what an asystole heart rhythm means.
In asystole, there is no electrical signals being produced by the hearts internal pacemakers. As we know from our previous trivia question a couple of weeks ago, with no electrical signal there can be no muscle contraction and so the heart has stopped.
Next lets look at what a defibrillator does.
A defibrillators job is to kick start the heart (and now I have the Motley Crue song in my head). It does this by turning the heart off by stopping it with an electrical current. With the heart stopped, we cross our fingers and hope that the brain recognises something is wrong and sends a signal back down to the heart to get it working again. Kind of like when you computer isn’t working so you turn it off and turn it on again, crossing your fingers that it’s internal circuits will work this time.
Putting these two bits of information together, if an aystole rhythm means the heart has stopped and the purpose of a defibrillator is to stop a heart we can now understand why using a defibrillator with an asystole rhythm won’t work. If the heart has already stopped it’s not possible to stop it more.
As I said, the good news for us first aider providers out in the community is that we use an Automated Defibrillator, that anaylses rhythms automatically and will only allow us to shock if it sees a rhythm that it could potentially fix. AEDs can seem intimidating if you haven’t practiced with one before. If you are interested in learning more and practice using an AED then why not attend one of my upcoming public courses or get some friends and family together for an in-home CPR training session for only $59pp.
Classes are fun and interactive and you leave with the confidence that you know what to do in an emergency. And the best part is, that you don’t need any prior experience. Contact me or use the book a course button below.
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Thank you to everyone who voted, if you would like to join in the next trivia poll, like and follow www.facebook.com/resusready
Have a question related to this weeks trivia, write it in the comments of the quiz post.
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