Medical Review of the Movie Flatliners 2/2

I’m continuing my review of the movie Flatliners that released last year which is a reimagined redux of the original 1990 movie.

In the movie, a group of medical students intentionally put one another into cardiac arrest so they can have a near death experience (NDE). Let’s examine medically whether or not their method would work.

The plan is to anesthetize the inductee with Propofol (which is a short term anesthetic), cool their core body temperature, and then defribillate them with electricity causing them to flatline. Keep in mind, asystole means there is no electrical activity happening in the heart. You can read a post I did here on how electricity or defibrillation really works.  Amazingly, in this medical center’s basement in another fully functional hospital with a very expensive MRI to be used during a disaster.

Issue #1: A medical center has a fully functional part of the hospital with an expensive MRI that is doesn’t use. Any empty, unused space in the hospital is a drain on the budget. Especially an expensive piece of radiology equipment. No sane hospital anywhere would be leaving that piece of equipment unused in a basement.

Issue #2: What they show is not an MRI. MRI scans take a long time and can never be done in 60 seconds.

Issue #3: Trusting a fellow medical student to resusciate you. Need I say more?

Issue #4: Knowing that they are going to put someone in cardiac arrest, no one really bothers to hook up a resuscitation bag.

Issue #5: During one code that begins to run several minutes, one of the students orders another to put the cooling blanket back on because “she’s too warm”. This flies in the face of every resusciation protocol there is. There is a somewhat well used phrase that you must be “warm and dead”. Suboptimal body temperature makes resuscitation more difficult. They are only making their job harder.

Issue #6: Endotracheal tubes have a balloon on the end that must be inflated to stay in place and deflated to take out. No one seems very concerned about this.

Issue #7: You cannot deliver electricity over clothing. Bare skin only. Also, paddles are really not used any more for a variety of reasons. Most hospitals have transitioned to patches. The paddles are used as a back-up.

Issue #8: Propofol is a distinctive milky white substance. Seems easy enough to draw up some milk in your syringe for the movie to simulate this.

Issue #9: You cannot shock a heart that is in asystole into a normal rhythm. You can see my post above for that. Can you shock someone into asystole? There is a rare possibility that you can shock someone and stop their heart. However, the common rhythms a person would go into because of this is V-tach and V-fib and not asystole. The movie depending on this rare event for every flatline is unrealistic.

Issue #10: You can tell when a shock is delivered to a patient because generally they have quite a few muscles contract. Patients never come up off the bed as dramatically as on film or television. In fact, I’ve never seen a patient come up off the bed at all.

Have you seen Flatliners? What did you think of the medical aspects?