Hollywood Style Resuscitation – Myths & Mistakes

After a long course yesterday, I decided I deserved a relaxing evening in front of our new TV. I was channel hopping when my attention was grabbed by a hospital scene: there it was, another in-hospital resuscitation scene. I heard a voice shouting “cardiac arrest” and then a stream of medical professionals rushed into the room, sending a very scared looking family member out of the room. The camera moved to the monitor and I saw a flatline on the ECG, the patient was dead. Within no time, a defibrillator was at hand, the patient’s chest exposed, a doctor rubbed big paddles against one another, placed them on the patient’s chest and delivered an electric shock from which the patient’s body jumped what looks like a meter high.

I have seen so many of them on TV and as always, I was angry at the (excuse the expression) rubbish shown. If it’s of any reassurance, reality is not like the scene I watched. There are so many “non-truths” on TV when it comes to medicine and resuscitation, it’s scary and sad. You would think that over decades of hospital and doctor’s series and soap operas, their medical advisors would teach them to correct these mistakes. But last night I decided it was time to talk about just a few of them.

  1. Two studies, one published in 1996 and another one last November looked at survival depicted on television. Both studies showed that in TV shows, nearly 75% of patients who suffered from cardiac arrest survived, a number far from reality.
  2. Most patients requiring CPR on television are young, ranging from 18 to 65 years, making the experience even more emotional for TV’s sake. In reality, more than 60% of CPR are performed on adults older than 65 years.
  3. A further misconception shown in movies that nearly half of the cases where CPR is required is due to trauma and serious injuries, where as in reality this accounts for only about 2 percent of all CPR cases.

We all know that TV is not a source of knowledge and we should take what we see with a grain of salt. I couldn’t agree more. But bear with me while I correct one very important mistake depicted during Hollywood style resuscitation and that is the resuscitation of a person with a flatline, or as it is correctly called asystole.

When a person goes into “cardiac arrest”, the heart no longer contracts or pumps blood through the body. This is either due to asystole or because the heart’s muscles are in an un-coordinated activity. In both cases, blood is no longer transported through the body and most importantly no oxygen is circulated to the brain.

A heart in asystole has no electrical activity at all resulting in the person having no heart beat, no pulse anymore.

The un-coordinated muscle activity of a heart of the person is cardiac arrest is most commonly “ventricular fibrillation”, a situation where the heart muscles flutter but do not contract the heart, also resulting in no heart beat and no pulse.

A person without a heart beat and without a pulse, loses consciousness, no longer responds and is no longer breathing.

The only way to provide the brain with circulation and oxygen at that very moment is by immediately starting CPR, cardio-vascular resuscitation, in the form of chest compressions and breaths. Yes, if you are preforming CPR on an adult, you may also simply perform chest compressions if you have not been trained in CPR (more on the topic of hands-only CPR in a future post).

The handsome Hollywood doctor however tackles the patient with his defibrillator and after one shock, or two, we can see the flatline is converted into a regular heartbeat again (Happy End). In reality, a defibrillator can only be used during cardiac arrest on a patient whose heart still has some electrical activity, as mentioned above, ventricular fibrillation. For the patient with a flatline the defibrillator will not be able to help: only the drugs that the rescue team administers, will help to bring that patient back to life.

Nevertheless, the key to survival in either patient is for bystanders to start CPR as quickly as possible. 

PS:

  • No, patients who receive a defibrillator shock, do not jump of the ground. You are more likely to see the person move as if they were startled.
  • It’s highly unlikely that the person, who is being resuscitated, regains consciousness after CPR for a minute or 2. It’s likely to take a much longer time, so keep up your hard work and continue CPR until professionals arrive and are ready to take over from you.


Are you ready to save a life? 

Photo credit: logoboom / Shutterstock.com

Posted on April 26, 2016 by

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