Question for cardiac or ICU nurses

[klone, MSN, RN]

Or hell, really any nurse who's not an OB nurse, because I have a feeling pretty much any other nurse can answer this.

So I'm watching Gray's Anatomy. A woman has asystole, but her husband is doing chest compressions because he doesn't want to let her go. As he's doing a compression, it registers a "beep" and a blip on the monitor. Is that an accurate representation? I thought the monitor registered the electrical impulses, rather than actual compression/squeezing of the heart muscle? (hence, pulseless v-tach)

[ScrappytheCoco]

The cardiac monitor definitely registers activity from compressions. Sometimes when you're doing them, especially on a pt in asystole, you'll get the v-tach alarm.

[Lev, MSN, RN, NP]

Yes, compressions do show up on the monitor. It can be a good judge as to the quality of compressions and as the PP mentioned, it can look like V-tach.

[KatieMI, BSN, MSN, RN]

This is one reason for "everybody off and stop" pause every 2 minutes during the code. For 10 seconds or so at least two people have to search for pulses on large arteries like carotid or femoral to determine if the "rhythm" on monitor is actually a perfusing one.

[Altra, BSN, RN]

Yes, it's accurate.

[canned_bread]

Great question - yes, they do show up. In fact, I have noticed I can tell "really deep effective compression" by whether it shows up on the ECG or not and how it shows up! If it's consistent and deep it shows up in perfect big wave forms. And, it does register a beep on some machines.

Even when someone has a heart monitor on, and moves around erratically, it still shows up. They can "fake the monitor"into thinking its VT or something! It's not electrical activity it just picks up, it's a movement too for some reason!

[Horseshoe, BSN, RN]

The first time I ever did CPR was at a large trauma hospital. I was working as a tech while in nursing school, and the nurses had a code on a guy they KNEW wasn't going to make it, but they had to do the code (he had shot himself in the head). They shouted, "Nursing student! Get over here and start compressions!" They were all watching the monitor and were using that to determine how well I was doing, which apparently wasn't very well. I was using way too light a touch. They coached me to go deeper. Finally, they said, "okay, good job, keep going."

I had no idea before that incident that the monitor would show anything meaningful during compressions. I had assumed it would all be artifact.

[Rocknurse, MSN, APRN, NP]

However, it's unlikely to be a single, solitary blip. While compressions are taking place there's major artifact on the monitor. During a compression pause to assess rhythm, there may be an underlying electrical activity but I suspect that single dramatic blip is for dramatic purposes only.

[klone, MSN, RN]

Sorry, wasn't a single blip. It was a rhythmic blip that mirrored the compressions.

[Ruby Vee, BSN]

And you get art line artifact as well. We can tell how good your compressions are by the blood pressure on the monitor!