Date: Fri, 3 Jan 2003 17:59:17 -0500
Reply-To: Stephen Steele <steeles@HORIZONVIEW.NET>
Sender: Vanagon Mailing List <vanagon@gerry.vanagon.com>
From: Stephen Steele <steeles@HORIZONVIEW.NET>
Subject: Shocking!; Was: Ground Fault in Westy?
Content-type: text/plain; charset="US-ASCII"
> It's all a matter of timing. If you have ever seen an EKG trace you know
> the heartbeat has a
> fairly complicated electrical rhythm. If a shock hits the heart at exactly
> the right point in
> the rhythm's cycle, you get ventricular fibrillation (not to be confused
> with atrial fib, which
> is fairly common and usually non-fatal). Once your heart is in V-fib, you
> are going to die, even if your trained SO is standing right there to start
> CPR. The CPR won't do any good, so unless they have a set of those paddles >
ready to zap you, say goodnight, Gracie.
Most of us who have functioned as paramedics for more than a few years have
witnessed first hand all the permutations that the heart goes through before
it enters into the only fatal rhythm... asystole. Which is BTW the only true
cause of (non-trauma) death
Bill N. is correct in that A-fib is fairly benign and manageable; most of us
will soon enough develop it as we enter the geriatric stages of life. Some
people live with it from childhood.
I will modify Bill's statement that "Once your heart is in V-fib you are
going to die" it is more correct to say that "Once your heart is in COARSE
V-fib you are going to die IF there is no intervention".
Fine V-fib can be corrected by something as simple as a stout, well-placed
blow to the sternum (a pre-cordal (sp) thump); I've done it. Lesser mounts
of defibrillation can, with timely administration, be used with amazing
results...
"OW!!! WHAT DID YOU DO TO ME?!!" she said as she fingered the red marks on
her chest and side. Three minutes earlier she had a purple death cowl from
her nipple line and up. She was a late 40's smoker with no previous heart
problems, who vagled (vagus nerve) down in the shower and started having
SEVERE chest pain upon awaking. Ten minutes later in the back of our squad
she was talking one second and gone the next.... COARSE V -fib big time.
I didn't bother with the electrode gel as she was still wet from the shower
and the water would conduct nearly as well. The ER doc was brand new to our
local hospital and accosted us for even attempting an uncalled for single
shock sequence, not believing that she could be talking so soon after a
severe heart attack. The following day at work he called us in and
APOLOGIZED ... seems her blood work up and our witnessed account jived. He
had never seen a full recovery from someone in her initial condition.
HOWEVER...... such outcomes are VERY RARE.
--
Stephen
Chillicothe OH
