Monday, June 19, 2006

Defibrillation or CPR?

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).

41 comments:

angel said...

You oso liuliu post?
:P

angel said...

Aiyah... that one is chou hei maa... so, hv to make it more dramatic :P

Red Sponge said...

Hey, my nurse friend told me about it too. I bet those hong kong drama makers never realise it.

Chen said...

angel,
I really very kek sem each time I see those scenes. It's more like they don't know the fact than they want to make it more dramatic. Pathetic :(

red sponge,
yeah loh.. After so many years also no improvement. Really no eye see.

L B said...

Msg from may in QuackQuackLand:
may [13:30:25]: just hit them hard on the chest, and if all else fails use a stake and hammer!!

L B said...

This not the same as getting CPR from Liucas!!!

Chen said...

May,
I want some quack-quack meat :P

LOL at your method .. luckily u r not my doctor (shiver), hahaha..

lb,
Liucas one is unique method, cannot find in medical books one leh.... which is also known as licking & kicking method :P

carcar said...

something interesting, but i dont know whats that... will check it out soon, you know lah, im busy now..kekeke

Mei said...

Oh yes, I so know what you mean ;)
And they always have their stethoscopes on the wrong way around too...

**sigh**

Chen said...

carcar,
this machine ah... very useful one..can use to shot kaw kaw that LB if he buat hal :D

Mei,
yeah.. annoying hoh seeing all that :)

day-dreamer said...

Hmm... I always thought what they did in the HK drama is what doctors in real life do too! Thanks for clearing up the air... at least I learnt something new today...

:P

What happens if you use that defibrillation?

Chen said...

day dreamer,
put it this way, most of the things regarding HK drama series related with medical field are craps. Imaging patient can undergo open heart surgery or major surgeries with just ventimask (this means the patient is still awake & can breath on his/her own while major surgeries is ongoing.. don't they know what is General Anaesthesia or GA ?

How can a doctor tell if a patient can survive the critical period overnight then he/she will be safe?
Nobody will knows exactly how long is the critical period. The condition might worsen anytime. I work in ICU for so many years already..

How can they give up resuscitating the patient & tell the family no hope liao while the patient can still breath & talk the last few words to the family members before they die?

The crap & stupid lists can go on & on. REALLY CRAPS !!! I'm really mad looking at this.

What will happen if use the defibrillator? Aiyak, I thought I write very clearly liao in my post? :P I even highlight liao the sentences with different colour leh.. :D

day-dreamer said...

Oh... hehe... missed it, paiseh.

Huh? Those HK drama all tipu one ah? Ceh! Do until so real, I thought it's correct one.

slurp! said...

i know HK dramas are always full of dramatic scene, trying to capture audience attention. TW drama also same same.

what you think about japanese drama like "Emergency room 24hours"? I always find i can learn something from Jdrama be it french cookery to herbs. and there always nice human touches injected into their drama

of coz love CSI, Grey's anatomy,ER as well. plot is nice & mind simulating.

Chen said...

day dreamer,
kekkee... I guess u r too tired liao? :P

HK one manyak tipu. Western one is way much better :)

slurp,
yeah loh.. dramatic but not realistic.

I didn't watch the japanese drama series "Emergency room 24hours", so I can't comment on that :)

The western medical drama series are much better... At least most of the facts given there are correct & more trustable.

Simple American said...

I remember when the first emergency kind of show appeared back in the 70s. You could count on one shock treatment every show. The defibulator is very sexy. Watch the body jerk and bounce off the table. Audience does not care about medical accuracy. They want drama and bouncing bodies Chen. ;)

izso said...

Chen : I tot u posted your hate for doctor shows on TV ages ago. Repost repost!

Chen said...

SA,
The body jerking and bouncing off the bed is too dramatic lah.. You hardly see that in real life. The body will jerk & bounce a little bit but not to that extend. If really the body bounced off like that.. u can see the chest wall “being burnt” already with the massive electric current. LOL Just like BBQ meat ;)

izso,
aiyoh, izso tai lou, as far as I remember, I only posted one post about my review regarding House MD medical tv drama series ,and that is it.. and the topic & content of the post is totally different leh :P I never touch anything about defibrillation & CPR there..

Frankly speaking, not many people realize the truth about the defibrillator. Do you? U might know about it but not everyone knows the fact, especially those who are not from medical field. So I have to point it out :)

Pink Cotton said...

WAH WAH is the defibrillator sth like the iron to iron clothes thingy??wahahaha..

domesticgoddess said...

other than no eye see, also can't help but laugh at the HK medic series/movies... they're patheticly fake and childish! i've given up watching those long time ago...

zeroimpact said...

Wah veli the interesting, though i m totalli lost in the naming convention...
I heard the part of CPR...
totally support CPR!!!

Chen said...

pink cotton,
wahwah… I never think of that.. can use that to iron clothes as well.. LOL (energy level range from 0 to 360 J). Abuse the equipment LOL

domestic goddess,
yeah loh.. I like the way u put it --> patheticly fake & childish :D
They thought we audience are soh kua :D

zeroimpact,
U want to learn CPR? There are BLS & CPR courses being conducted every now & then. It's good to know the basic CPR skills.

agus said...

Only in Hong Kong or have you seen it in ER or Third Watch?

I wouldn't know. And all these medical terms are making me dizzy. Urg...i'm under cardaic arrest! Help! CPR first, please....then defibrillation...

zeroimpact said...

Kek kek kek
I guess I have to relearn all the things they taught mi in St John Ambulance Society
:)

eve said...

haha..may i add a few things..most of the time when they defib on tv , the places r all wrong , n they love to rub the 2 electrodes togeder..n oso they always forget abt putting gel on the body...apa lagi , sure bbq ler...another thing , if they even try to CPR , the chest compression technique is all wrong....i know exactly how u feel , cos me n hubby feel the same everytime we chanced upon such scenes on tv...i like the western medical series better, at least not so much por ma drama la...hehe..

L B said...

Someone mentioned "B B Q"? Mmm, BBQ Sotong!!

Chen said...

agus,
So far I only noticed that in HK series (I don’t watch Taiwan, Korea or Japanese series, so I can’t comment on that). Western medical series like ER or Chicago Hope are better .. I didn’t watch Scrub or Grey’s Anatomy or Third Watch :)

Choy.. where got people say they themselves are under cardiac arrest?? Hahhaa…. U must be mabuk liao? From the residual tuak effect after Gawai Festival? LOL

zeroimpact,
Oh, so u have learn something about CPR. Yeap, one needs to take refresher course regarding CPR every 2 years ;)

eve,
I can’t disagree with u. Lifting up both hands & legs to agree with your statement :P ---> Rubbing the 2 electrodes together, then apply the electrodes straight to the chest wall with gel bla bla bla… wrong compression technique (the arm supposed to be straight and they are not supposed to bend the elbow), compression at the wrong site (too high or too low down)… hahaha.. the list really continues :D

Yeah, western medical series are much more better.. at least after I watch, I won’t feel sakit hati

lb,
BBQ Sotong? LOL.. Sotong post will be up very soon… stay tuned :P

L B said...

W H E R E I S T H E S O T O N G P O S T ?

Chen said...

lb,
still half way baking inside the oven :P Tunggu sekejap lagi lah..

L B said...

You know how many hits I've struck, waiting for Sotong Seminar to start? LOL!!

angel said...

darn! i've been conned! just now u say gonna be up soon and now sudah nearly 1 jam, belum up lagi wan?? liuliu lah!!

L B said...

angel, Sotong Chen gone fishing at Batu Ferringhi now..

angel said...

OMG! Sotong LiuBee, I think i oso gonna bcome sotong liao bcos i thot the Doc replied and I read it a few times wondering, how come she called herself as Sotong Chen! hahahahaha!! so liuliu!!!

L B said...

liuliuliu!! SotongAngeliuliuqueen.. your name gonna be soooo long !!!
Maybe the Sotong got her instead?!!

angel said...

*throws a float into the sea*

*looks around to see if there's any Great Whites*

Chen said...

lb,
sorry lah LB, Manyak sorry.. oven rosak just now.. So have to rebake again :P Actually I just came back home lah... Got something to do just now.

angel,
sorry again lah.. Just reached home..
(unexpected delay).

lb,
aiyak.. I haven't even makan dinner lagi leh.. where got time to go fishing :P

angel,
liuliu lah u. Welcome to the Sotong club. U r definitely qualified cos of your "blurness" hahahha...

lb,
her new name is Sotong angeliu :) Nice leh?

angel,
apa tu?

L B said...

All HAIL Sotong Chen!!

Chen said...

lb,
I guess this club will last for few days only.. hahaha :D

cooknengr said...

What's up Doc, I know why they use Defibrillator instead of CPR, it cost a lot more to pay 劉華德 for a mouth to mouth CPR with 任達華 scene!

Pandabonium said...

Good reminder to me to get my CPR certification updated. Anyone who has the opportunity to take the course should do so.

Chen said...

cooknengr,
hahaha… that’s a good one :)
Mouth to mouth CPR is only performed on roadside. In hospital we have face mask & ambubag to do the trick ;) I guess not many people are willing to do mouth to mouth CPR nowadays on unknown person except on close family members - cos of the unknown risk :)

pandabonium,
Yeah. It’s good to know the CPR skill. It is not difficult and it can be learnt within a day :)
All it takes is the effort ..