In dramatic movies and TV shows they will occasionally show an injured character flatlining. The doctors will then call for the “paddles” and shock the person to restart the heart. Is this the correct treatment protocol for asystole? Briefly explain your answer. Please post your answer and also respond to the answers of at least two of your fellow students.
The portrayal of healthcare treatments in dramatic movies and TV shows often deviates from reality for the sake of entertainment. One such example is the depiction of using defibrillator paddles to revive a flatlining individual. In reality, using defibrillation for asystole, which is the absence of electrical activity and cardiac contractions, is not the correct treatment protocol. In this essay, we will discuss the appropriate treatment for asystole and why defibrillation is not effective in such cases.
Asystole is a life-threatening condition where the heart stops pumping blood to the body. It usually occurs as a progression from other fatal cardiac dysrhythmias such as ventricular fibrillation or pulseless electrical activity. The American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) make it clear that defibrillation is not recommended as the initial treatment for asystole. Instead, the primary interventions for asystole involve high-quality CPR with immediate recognition, activation of emergency response, early defibrillation if ventricular fibrillation or pulseless ventricular tachycardia are present, and the administration of medications.
There are several reasons why defibrillation is not effective in treating asystole. First and foremost, defibrillation is designed to treat ventricular fibrillation, which is a rapid, chaotic rhythm of the ventricles. In ventricular fibrillation, the heart muscles quiver instead of contracting effectively, thus preventing the heart from pumping blood. Defibrillation delivers an electrical shock to the heart to depolarize the cardiac cells and momentarily stop all electrical activity. The hope is that the heart’s electrical system will restart with a more organized rhythm after the shock is delivered.
However, in asystole, there is no rhythm to shock back into a normal pattern because there is no electrical activity. Asystole represents a complete absence of electrical activity within the heart, making defibrillation ineffective. Shocking a flatlining person would be futile as there is no electrical impulse present to bring the heart back into a normal rhythm.
Secondly, asystole usually indicates a non-shockable rhythm. Non-shockable rhythms, such as asystole and pulseless electrical activity, have no mechanical activity in the heart. These rhythms are typically due to cardiac arrest caused by factors such as severe hypoxia, metabolic abnormalities, or massive myocardial infarctions. In such cases, defibrillation would not provide any benefit since the underlying cause of the asystole needs to be addressed.
Instead of defibrillation, the AHA guidelines emphasize the importance of high-quality CPR in managing asystole. CPR helps maintain blood flow to vital organs until further intervention is possible. It involves chest compressions to manually circulate blood and rescue breaths to provide oxygen to the lungs. By performing CPR correctly, one can deliver oxygen and some degree of blood flow to the body, ensuring that vital organs sustain minimal damage.
Furthermore, prompt administration of medications is crucial in the management of asystole. Medications like epinephrine and vasopressin are given during CPR to support blood pressure and improve coronary and cerebral blood flow. These drugs aim to stimulate the heart to increase contractility and promote perfusion to vital organs.
In conclusion, the portrayal of using defibrillator paddles to revive a character experiencing asystole in dramatic movies and TV shows is not accurate. Defibrillation is not the correct treatment for asystole as it is designed to shock the heart out of chaotic rhythms like ventricular fibrillation. Asystole represents the absence of electrical activity in the heart, making defibrillation ineffective. Instead, the appropriate treatment for asystole involves high-quality CPR to maintain blood flow, immediate recognition and activation of the emergency response system, and the administration of medications to improve coronary and cerebral perfusion. It is essential to understand the appropriate protocols for the management of asystole to ensure accurate information is portrayed in media and to prevent the dissemination of erroneous medical practices.