Authors, television producers and scriptwriters are fascinated by the use of electricity. This is probably one of the most commonly abused medical scenarios in that it is rarely used correctly.
One of my most popular posts here at Redwood’s was a post titled Shock Me To Death that highlights how electricity (or defibrillation) should be used.
I was reading a debut novel by a medical doctor and found many grievous errors around the use of electricity. Which distresses me because he also said he had a cardiologist review the manuscript. Seriously, I kind of want to know who that doctor is and what kind of training he had.
There was the usual error of shocking a flatlined patient or asystole. Remember, in order for electricity to work, there has to be some present. If a patient is flatlined, there is no disorganized cardiac rhythm to reset and so defibrillation is contraindicated in those patient scenarios.
Next error in this manuscript was cracking the sternum down the middle during compressions. For one, the sternum is extremely hard to fracture. It’s designed to protect some very important organs. If the sternum is even slightly fractured, we know there have been extreme forces placed on that patient. So, to have mere hands fracture a sternum all the way down the middle is ludicrous. Remember, they saw this open for open heart surgery. Breaking ribs is very probably during CPR, but not the whole length of your sternum . . . sorry.
Last, and most creatively (as I’d never seen this error before), was the amount of electricity used in an ICD device (an implanted cardiac defibrillator.) ICD’s are devices that are used to convert patients from lethal arrhythmias like v-fib and v-tach. They are not pacemakers– which stimulate the heart to beat.
Whenever electrodes are placed near the heart, the amount of electricity used is very small. Think about it. When we shock you from the outside of your body, the electrical current has a lot of tissue to pass through to get to your heart. This is why we use more. When defebrillating someone– it’s in joules.
A pacemaker uses a lot less energy. Outside pacemaker use milliamps.
And here is the very interesting quote from a published novel:
“Cardiologists shock patients all the time under controlled conditions, remotely dumping up to 700V (volts) of juice directly in to the heart via the ICD.”
Wow. That’s just . . . overkill.
Just how lethal is 700 volts applied directly to the heart?
This site explains that 110V can kill you.
It’s so egregious an error that I’m not quite sure what this author was thinking. It pains me more that he is an actual medical doctor. I even double checked the published manuscript (as I’d read a galley proof before) and the error was still present.
I think he needs a new cardiologist.