Monday, May 05, 2008

Hang On and Shock 'em

Young cardiology fellow meets electrophysiologist after an episode of new-onset atrial fibrillation that requires cardioversion in the EP lab:
"Go ahead, hold the legs."

"Are you nuts?"

"No, I'm not nuts. You need to hold their legs so after the shock they don't bend their legs with all those catheters in them and hurt themselves."

"But you're going to use 360 Joules!"

"Yep, and you won't feel a thing."

"No way."


"How can you be so sure?"

"Because those gloves you're wearing do not conduct electricity. Sync on? Good. Everybody clear? (No not you - you keep holding...) Go ahead."

* * * Thump * * *

"Didn't feel a thing, did you?"

"Ah, no, but now my heart is racing..."


Reference: Lloyd MS, Heeke B, Walter PF, Langberg JJ. "Hands On Defibrillation. An Analysis of Electrical Current Flow Through Rescuers in Direct Contact With Patients During Biphasic Defibrillation." Circulation. 4 May 2008.


Anonymous said...

Are they heavy duty rubber gloves or just thin gloves like the latex ones that are in the box? Do you get many volunteers to hold the legs? If I had never seen a cardioversion before, I would be freaked to hold the legs.

DrWes said...

Anony 12:24 -

The plain ol' latex ones work just fine.

Ian Furst said...

I see your "it's ok to hold onto a patient you're converting" and raise you a nurse (I worked with) that leaned against a scrub table during a cardiac case when they used the internal paddles (her elbow was touching the instrument tray) and got knocked on her ass. She claims to have felt the jolt, fell over then looked up and said "that's the best orgasm I've ever had".

She then went to emerg to get checked out. Urban legend? Don't think so but she made me laugh my ass off even if it is.