Defibrillation question

Nurses General Nursing

Published

As seen in a commercial for an upcoming TV show episode ---- hospital scene, pt laying (lying?) flat in bed/stretcher, side rails down (OK). Male MD/nurse (?) with defib paddles in hand, paddles positioned over sternum/left lateral chest (OK-ish), ready to fire.

Here's the kicker --- pt in a hospital gown, no gel pads; therefore the defib firing attempt would be thru the gown!!??!!??

Now it's been eons & eons since I last used a defibrillator, but don't you still have to make direct contact to the gel pads on the bare chest? Not thru fabric? Uhhhh - i'is there something new out there in defibrillator land? Or did I just see another DUMB incorrect

over-dramatized made-specially-just-for-TV spectacle?

We used chest gel pads for AED training, so wouldn't this be applicable to general defibrillation also. I love catching medical bloopers on TV, so this just jumped out at me!

So... did I catch a blooper? Thanks.

Specializes in PICU, Sedation/Radiology, PACU.

One of my favorite medical inaccuracies from Grey's Anatomy is how often they convert an abnormal rhythm (sometimes v-fib, sometimes asystole) using a precordial thump. The kicker is that they usually try the thump after several rounds of defibrillation.

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Specializes in Allergy/Immunology.
When taking my BLS course we were instructed to remove the person's shirt and to even try to remove any hair on the person's chest if we could but who really has time to pull a razor and some shaving gel out at a time like that?
lol yea, they told us if we couldn't get an accurate reading to remove the pads quickly, in turn removing the hair, and reapply with new pads. I had to giggle a little bit thinking of a waxing.
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Specializes in Allergy/Immunology.
If they are really hairy, you can use the first set of pads to "give them a wax" and then apply a new set of pads.
lol I just read this after I posted :)
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Specializes in CICU.
No, it's done on bare chest. And justbeachy, the shocking asystole on tv drives me insane. I quit watching hospital dramas because I can pick out mistakes. Shocking asystole in real life can cause damage to the myocardium. The odd thing is, these shows have a medical consult.

I just think its funny that they do a better job on daytime soap operas than in movies or prime time... Not that the soaps are accurate by any stretch...

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Specializes in ICU.

Shocking asystole drives me insane as well! Lol, the pp who mentioned that shocking asystole can cause damage to the myocardium...does it really matter at that point?? I get what you're getting at though...heart could start or at least fib after some epi, but still funny=P

I love the shows where the intubated/comatose patients look so perfect...sitting up in bed with 1 pillow behind their head, no restraints, no Q2h turning/repositioning/mouthcare...(not that the general public wants to see all that stuff but still seems silly to me...I'm like noo!! Pressure ulcers! VAP!)

Also recently saw a show where the audio of the heart monitor was going probably around 120bpm, while the screen showed a nice sinus rhythm in the 60s...

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Specializes in LTC/REHAB/GEROPSYCH/WOUND CARE/ICU.

Years and years ago.... I did a precordial thump on a 36 years old woman who was having a unstable V-tach ; I was passing by her bedside when I saw her eyes rolled, loss consciousness to do precordial thump and her monitor promptly showed V tach.,I had no defibrillator beside me .Just had my ACLS class then so it was really fresh in my mind. Did the precordial thump and started cardiac massage at the same time calling a code. Our team was fast enough and we were able to revive the patient. That was one experience I won't ever forget- that was the one time I did precordial thump and it saved a life. The woman was very thankful when she was discharged from ICU.

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Now I question everything I learned on ER :(

I think it was last season that they just finally pushed me over the edge. Something about they were treating hyperkalemia when the problem would have really been hypokalemia or vice versa. It's like a I get the other mistakes, but if you're going to go complicated enough to talk about jacked up electrolytes, jack them up right!

I just think its funny that they do a better job on daytime soap operas than in movies or prime time... Not that the soaps are accurate by any stretch...

Don't be so sure. Young & Restless had David Hasselhoff play a doctor not so long ago. In no world does that work. :)

I love the CPR on tv/movies. The flailing elbows are awesome!!

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Specializes in retired LTC.

Thanks so much to all!!! I've been in nsg soooo long, that I thought , weeellll, just maybe....... But this just caught me off guard. Then I'm trying to justiify that maybe in REAL LIFE, maybe if the pads were UNDERNEATH the gown...... maybe......duh!

As I said, I like to catch medical bloopers. I esp like when they do CPR with the pt sitting upright 90 degrees in bed and they're doing some weird compressions... Or when they do defibrillate, everybody is holding on the rails. Or firings on bare chests - I swear that I could almost smell it! Oh yeah!

Siderails are my pet peeve though. Any show that pulls UP the rails gets my thumbs up:up: (I mean, I even pull up siderails when I'm waiting for the FH to come in for a deceased resident in my LTCs!!)

You'd think with the budgets available for these shows and advertisements, that somebody would be paid for better reality consultation.

Thanks again.

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Specializes in ICU.
Siderails are my pet peeve though. Any show that pulls UP the rails gets my thumbs up:up: (I mean, I even pull up siderails when I'm waiting for the FH to come in for a deceased resident in my LTCs!!)

Lolll I do the same thing! I think I'm subconsciously paranoid that the (deceased) patient is going to somehow roll off the bed...:cautious:

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lol~~~stick with what you learn from medical book. If you follow the procedures in hollywood movie, I'm afraid you'll never see your patient alive in 'next episode~~~'

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When taking my BLS course we were instructed to remove the person's shirt and to even try to remove any hair on the person's chest if we could but who really has time to pull a razor and some shaving gel out at a time like that?

Dry shave with a disposable razor, or use clippers if your facility supplies them. Good skin contact is essential for effective defibrillation, and a little razor burn is the least of a pulseless person's worries.

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its TV, relax.....

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