how many times can a human be defibrillated?

mscsrjhm · Aug 2, 2004

Oddist code I ever saw. Years ago, 36 y/o walked into ICU-IKG with eminent MI, so we were ready.

His eyes were open, looking right at us, FOCUSING while we coded him.

7 defibs. first one seemed to really wake up those eyes.

#2,3,4,...HE CLAPPED with each shock!!!!!! hands came up, connected!!!.

(Way to many witnesses to call me crazy-)

CLAPPED!!!!!!!

We lost him, but that was one of the most intense things I have ever experienced.

Celia M, ASN, RN · Aug 2, 2004

Jenni,

So sorry about your Dad, my condolences. You did the best for him and got him to an ER. It's difficult for a nurse to have a sick relative, you try to treat them as another patient but it doesn't work, for me all logic and nursing knowledge seemed to fly out of the window when my Mom was seriously ill. My thoughts and prayers are with you.

Celia

CCU NRS · Aug 3, 2004

Thank you for the many replies. This didn't happen to a patient in my ER, it happened to my dad 2 weeks ago. My father passed on July 19th. He was 48 years old. No cardiac history ( many risk factors, family hx, 2 pk/day smoker, obese) No medical history, no home meds.
2 caths, 2 stents, balloon pump, every drip you could name ( cardiologist told me "your father has more drugs going in him than any other patient in this hospital") put him on a vent so his heart could rest.........
he was not a candidate for lvad,or complete bypass d/t weight of 313, they wanted him to get. "stable" so that an internal defibrillator could be placed........... he just couldn't get stable.
I guess i've never seen anyone so sick, I mean my dad walked out to my car with cp rated as a" 4". I took him to an ER 2 minutes away from his home, small ER ( not the one I work in) cuz "time is muscle" right????
He ended up at OSU medical Center , where the staff was wonderful, my dad just couldn't be saved. I guess I'm just having a hard time with the sickest person I've seen being my own father. having a hard time with him walking out to my car, and me joking with him while he was stable and getting worked up, about possibly "getting a foley".
I love my dad! Thanks again so much for your insight into something that was really out of my control.
xo Jenni

God Bless you and I am sorry to hear about your father. I lost my father last year and it is always hard as a nurse, when I see pictures of him now even 5yo pics I can see he was sick, but I never really noticed it while he was alive, we can not beat ourselves up over the things we can not change. Good Luck with your grieving and recovery.

timewood · Aug 3, 2004

hello there...

i am so sorry about your dad and i know that you must miss him so badly. my father died suddenly just a little over a year ago and this past year has been one he!! of a coaster ride of emotions.

i just wanted to let you know that you are not alone...my father and i were very close...no-one understood me as well as he did...grieving is a complex process...be patient with yourself.

my best thoughts and wishes are with you and your family.

needdynurse · Aug 3, 2004

First Of All ,sorry For Yor Loss,god Be With You And Yours.

Defibrilation- From What I Have Seen As A Crtical Care Nurse/rt

An Individual Fully Grown Male Or Female,can Be Defibed As Of Then As Necessary ,providing They Have A "course Fib," A Flat Line Is Imposible For Getting Someone Into Normal Sinus Rythm(period)....

On The Other Hand As Far As The Number Of Times On Corse Fib. Is

Directly Proportional To Adapost Tissue Between The Chest Wall And The Sa- Av Nodes-it Also Depends On The Number Of Jewls The

Attending Physician Orders To Defibrilate With.can You See The Reasoning There? Don't Diddle Around Start With Body Age And Fat.

Unpleasant But I Hope It Helped --------nrsdug

cardiorehabrn · Aug 10, 2004

So sorry about your loss.

I worked with CABG patients for years. I had a male patient who kept going into VT for two days post surgery. He was shocked with regularity it seemed like every hour during my 12 hour shifts always going back to NSR. He finally recieved an ICD and multiple drug changes that kept him in NSR. He left the ICU after two weeks to the step down unit. He went home about a month later.

needdynurse · Aug 11, 2004

I think the most I've ever shocked one patient was 8 or 9 times. He was a post cath stent to the RCA with reperfusion v-fib/v-tach. The first time he went into vfib it took 3 shocks to regain a rhythm. I used the biphasic defibrillators that only reach a 170j maximum. After that he had a few more episodes and eventually stopped (probably a combo of shocking and being loaded with amiodarone 3 times). We left the handsfree pads on him and shocked when needed. Interestingly enough, each subsequent shock needed less electricity (around 100j). He walked out of the unit 3 days later.

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Question: What ever happened to Precordial thump on vt pts?

How many jules were used 8 or 9 times how big a patient M/F?

Someone please send me an answer? :uhoh21: needdynurse

jewelcutt · Aug 12, 2004

I was taking care of a biVAD patient once with whom the previous night shift had shocked 25-30 times over the shift for Vfib. Technically the

VAD will perfuse the body, but prolonged VF can lead to ventricular tissue ishemia (which is what we're trying to prevent with a VAD in the first place and allow the ventricle to rest) so we have to shock VF. The CV surgeon had heard about the number of shocks and was angry that we had shocked so many times, saying something about damaging the tissue. My question is, do you think prolonged VF or mult. shocks damages cardiac tissue more?

suzeeq · Aug 12, 2004

What is gtt, I only know it as glucose tolerance test.I gather it has to do with drug doses?

cardiorehabrn · Aug 13, 2004

What is gtt, I only know it as glucose tolerance test.I gather it has to do with drug doses?

It means drop.:)

henrysmom · Aug 14, 2004

I remember a man about ten years ago, s/p CABG and valve who went into every imaginable rhythm for days afterwards, torsades, Vt,Vfib, etc. We probably defibrillated this man 40 or more times and had a zoll pacer for brady etc. He was extremely, and I mean extremely sensitive to any problem with his lytes, and was requiring tons of K,Mg, Phos, etc to stay on top of his losses. All he'd have to do was pee and he'd go into Torsades. He actually had a sense of humor about it all and after a few days things calmed down (after his post-op diuresis in retrospect) and he actually walked out of the unit with a very sore chest...Came back to visit us a few months later..

RNCENCCRNNREMTP · Aug 14, 2004

I've only been an ER nurse for a year, so i haven't seen much, most i've seen someone shocked is 4 times............... but
have you ever had a patient on your unit, say in cardiogenic shock, goes into long runs of vtach, and needs to be shocked 7-8 times every 18 hours for 6 days?????
I've attempted to research "effects of repeated defibrillation" with no luck. I only know that each shock is like running a mile to the body.
Just wondering if any of you CCU nurses have seen this, and if you've seen survivors.
Thanks in advance
Jenni

I have never heard about the running a mile anaology. I did research in nursing school (biomedical engineering minor) and we did doggy defibs several dozen times per dog with no significant effects (these were both external and internal defibs). I once took care of a man with refractory torsade de pointes VT and in 8 hours he got shocked about 80 times (200-360 joules). Once we stayed converted he did very well and is still alive today (10 years later) and doing well.