Defibrillation question

[amoLucia]

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.

[Penelope_Pitstop, BSN, RN]

its TV, relax.....

I wish I could, haha. My mom, boyfriend and best friend are all "Grey's" fans and have banned me from watching said show in their presence.

One episode featured an M & M or some sort of similar review concerning a code gone awry. My mom almost hit me when I pointed out that the patient died because they didn't follow ACLS, not for the implied reason. Similarly, I have a friend who works in the ME's office and can't stand NCIS because of its errors concerning forensics.

[wish_me_luck, BSN, RN]

haha, delana. Sometimes, I think they purposely make the errors/do things that aren't right just to keep health care personnel entertained/on their toes. LOL

[K+MgSO4, BSN]

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!!)

Interesting, side rails have to be down with 95% of the patients that I have worked with in Ireland and Australia. It is an increased falls risk to have them up. If a pt is going to climb out of bed it is further to fall. Admittedly we have one piece side rails on our beds like these Medicraft 700 General Ward Bed (actually I bought 20 of these when I set up my ward!) because it is only a one piece side rail there is a risk of the pt who is confused, climbing up and over them and falling further to the ground.

For those higher falls risk patient they get this http://www.uniquecare.com.au/safecare-floor-bed.html

any how hijack over......have you ever seen the CPR and the bagging on 3 rivers? terrible! I was watching Hawaii 5-0 and stayed on the channel and was watching them bag a pt1,2 big pause 1,2 big pause. And a guy doing CPR stopping to check for breath sounds all over the chest saying "no pulse" well duh!! not found in the R)lower lobe of the lung

[psu_213, BSN, RN]

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?

I was taught to put the pads on over the pads and rip them off (and hopefully rip the hair off with them). Then, put a new set of pads on and shock away.

[psu_213, BSN, RN]

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 used to like House. Then they had a moment when a guy threw a clot into his retinal artery. One of the 'team' said "we need to start warfarin stat to break up the clot." Later in the day, clot was gone. That's when I began to think the 'medical consultant' was just a fictional name they put in the closing credits.

[Anna Flaxis, BSN, RN]

I was taught to put the pads on over the pads and rip them off (and hopefully rip the hair off with them). Then, put a new set of pads on and shock away.

Which is fine if cost is not an issue (pads are expensive), and as long as you have two sets readily available.

[psu_213, BSN, RN]

Which is fine if cost is not an issue (pads are expensive), and as long as you have two sets readily available.

In our ER we have lot's sets of pads available (although I'm not sure how it is in other units) and...well...cost never seems to be an issue during a code (but that is a different discussion).

[nurseprnRN, BSN, RN]

Somebody did a survey of TV cardiac arrests and found that the recovery rate in TV ERs from cardiac arrests was something like 96%, when, of course, in real life (or should I say, real death?) ER arrests are successful only about 19% of the time, and of those, not all live for 30 days or even get out of the hospital. When these data were presented to the TV show "ER" with the note that their show was giving real people grossly unrealistic expectations of what will happen to a loved one post arrest, the show altered their recovery rate and showed more deaths and called-off codes. I don't see Grey's or House giving that much of a dayem about that, though.

There's a great effort being put forth by a nurse at TruthAboutNursing.com to improve the accuracy of media presentations of health-related subjects, particularly about nursing. They have a blog and welcome both positive and negative feedback on shows (like that godawful Dr. Oz show that showed "nurses" with deep cleavage and peek-a-boo red lingerie dancing onstage to illustrate the idea of exercise for cardiac patients, with the sexist remarks you can imagine with no further hints...oh, god, that was bad) and links to where you can send correspondence to producers and advertisers.

[classicdame, MSN, EdD]

I saw a show recently where the patient coded and one male was the ONLY person in the room, besides the two actors who were merely friends of the patient. Running a code on his own (and with the gown on). Do not confuse fact & fiction.

[amoLucia]

GrnTea - what a font of wisdom you are!!! I think it coincidental to mention that TV commerical I discussed showed the male figure (MD/nurse?) with the defib paddles. But there was also a female figure (nurse?) just standing at the foot of the bed. It was a super short commercial so there was no way to tell who was who.

So much for reality depictions in the media!!!

[hiddencatRN, BSN, RN]

Welcome to the wonderful world of Hollywood! YEARS ago, I saw blood being given (on a soap opera) from a glass bottle, and if you followed the tubing, it was going into the patient's nose. I 'bout wet myself I laughed so hard!

Maybe it was a tube feed for a vampire?

[amoLucia]

Welcome to the wonderful world of Hollywood! YEARS ago, I saw blood being given (on a soap opera) from a glass bottle, and if you followed the tubing, it was going into the patient's nose. I 'bout wet myself I laughed so hard!

Maybe it was a new treatment for fluid loss reversal for epistaxis?