One of the common scenes we see in medical tv drama series or medical movies are (especially Hong Kong drama series & movies) is when someone with cardiac arrest or asystole (whereby the heart stopped beating and the cardiac monitor shows a flat line ) being pushed into the Emergency unit, the medical doctor or health personnel will apply the defibrillator and start to defibrillate the patient (which is normally referred to as "giving shock").
After defibrillating (giving shocks) the patients few times and if their effort is fruitless, the patient is pronounced death. I am pretty mad and really hate it when I see such scenes. Cos this is pure nonsense !!! What an insult !! They think the defibrillator can work wonders? CPR is the keyword in such cases, not the defibrillator. The message conveyed is very misleading. For someone who had cardiac arrest or went into asystole, CPR should be performed immediately (CPR or Cardio Pulmonary Resuscitation here means chest compression & rescue breath/intubation, and giving drugs such as adrenaline & atrophine) and definitely not defibrillation - which is used in Advanced Cardiac Life Support/ACLS in certain cases only!!!!! )
Electrical defibrillation should definitely not be applied indiscriminately to patients in asystole. This is not only fruitless, but also detrimental; eliminating any possibility of recovering a cardiac rhythm. Why so? It is because asystole following electrical defibrillation will worsen the outcome and produce a "stunned heart". Empiric shocks to asystole can inhibit the recovery of the natural pacemakers in the heart and completely eliminate any chance of recovery!
Most of the time, only the cardiac arrest with rhythms such as Ventricular Fibrillation (VF) and pulseless Ventricular Tachycardia (VT) are defibrillated. There are also other heart rhthyms that can be defibrillated or given synchronised cardioversion when the patient is not in cardiac arrest, such as supraventricular tachycardia (SVT) or fast Atrial Fibrillation (Fast AF).