My Pet Peeve of the day: You do not shock asystole

[DVCLiz]

I'll watch stuff I'm interested in. I watch House all the time. Most of the errors I just don't care about. They register in my head but are in and out, zippity quick.

The asystole thing, though. It's the one absolutely baseless thing that they all do and they do it ALL THE FLIPPIN TIME. So much that if you walked up to Joe Schmoe on the street and asked what doctors do when people flatline, they'd say that they get the paddles. It's that ingrained in our media.

Thing that make you go, "Ugh." Pet Peeve of the Day.

Cool - Beans, just nosy - what is your job???

 

[monkey68]

I'd love to hear someone on TV say, "wenckebach." Everyone in the country would be saying, "Winky what?" But it'd be cool.

They could throw us a flippin bone, KWIM?

Just for that.... http://www.youtube.com/watch?v=GVxJJ2DBPiQ

 

[mickeymedic]

Can't cut people's clothes off on TV.

Depends on what channels you're watching

Drives me nuts! I'm getting ACLS certification in a couple weeks, and my school held an EKG review for us. Not really just for the ACLS class, but a review of reading EKG's doesn't hurt, since we will be on rotations in a few months. Anyway, he puts up a flatline EKG, tells us "This is asystole. Only shockable on ER".

I'm going to have to borrow this line the next time I'm teaching.

Yeah, my husband refuses to watch medical dramas because he hates hearing me point out all the mistakes.

My hubby got peeved during one of the james bond movies when james was injecting himself with something to control an arrythmia and I went berserk on how WRONG that was.

I remember that scene! I forget what TV show I was watching...but someone coded in the elevator and the doctors had a Medtronic CRplus AED. They somehow visually analyzed the rhythm, "charged to 360" and shocked with paddles. For those not familiar, this AED (automated external defibrillator) does not have a screen to view the rhythm, and only has two buttons - the "on" button and the "shock" button. The rest is "automated" - ie the machine does all the work. Oh, and there are no paddles...just gel sticky patches. But that's another comment (see below.)

I'd love to hear someone on TV say, "wenckebach." Everyone in the country would be saying, "Winky what?" But it'd be cool.

They could throw us a flippin bone, KWIM?

ITA

I'll watch stuff I'm interested in. I watch House all the time. Most of the errors I just don't care about. They register in my head but are in and out, zippity quick.

The asystole thing, though. It's the one absolutely baseless thing that they all do and they do it ALL THE FLIPPIN TIME. So much that if you walked up to Joe Schmoe on the street and asked what doctors do when people flatline, they'd say that they get the paddles. It's that ingrained in our media.

Thing that make you go, "Ugh." Pet Peeve of the Day.

For those of you who work in the hospitals...do your defibrillators still have paddles? Out on the ambulances we switched everything over to hands-free patches several years ago. I'm not even sure that paddles are an option on the newest monitors. On TV it seems that they are all still using paddles...I know it's more dramatic to straddle the patient, push the paddles against their chest and yell "CLEAR" than to slap some patches on and stand at a safe distance pushing a buttom.

 

[Cool-Beans]

Just for that.... http://www.youtube.com/watch?v=GVxJJ2DBPiQ

I've seen that before. Hadn't heard the original song yet, either...so I had to listen to that, too.

Liz, I'm a nurse and work in the cardiac field.

 

[Pea-n-Me]

For those of you who work in the hospitals...do your defibrillators still have paddles?

We have everything we might possibly need for any situation.

 

[pls5286]

We used to cut up and say "shock it till you recognize it...then you stop" We used to watch Rescue 911 and shows like that and critique them. A favorite pet peeve was the Non rebreather not filled up.

 

[mickeymedic]

We have everything we might possibly need for any situation.

What type of situation would paddles be superior to patches? Just curious.

 

[monkey68]

For those of you who work in the hospitals...do your defibrillators still have paddles? Out on the ambulances we switched everything over to hands-free patches several years ago. I'm not even sure that paddles are an option on the newest monitors. On TV it seems that they are all still using paddles...I know it's more dramatic to straddle the patient, push the paddles against their chest and yell "CLEAR" than to slap some patches on and stand at a safe distance pushing a buttom.

I don't work at a hospital, I'm still in med school, but I have done some observing and such, I have been to at least one hospital that still uses paddles, didn't pay attention at the other places. But this is also an inner city hospital that is generally understaffed and very little money for all sorts of gadgets, they didn't even have an MRI machine at this hospital. If a patient needed an MRI, they were sent to another hospital.

When I got my BLS card last year, we were trained with the AED's with the sticky pads. Course, on the training models, the sticky pads are no longer sticky, and fall off the mannequin, but it's still the same idea. Turn it on, let the machine determine if it's shockable, make sure everyone is clear, push the button. Not quite as much drama though... actually, I don't think I've ever seen an ED with as much drama that goes on on ER.

Oh, the other thing that really bugs me is on Grey's Anatomy. Ortho is it's own residency program, so how was it possible for Callie to become the surgery chief resident? And why are surgical residents spending so much time on neurosurgery cases, where are the neurosurgery residents?? And don't get me started on all the illicit relationships going on. Granted I don't have much hospital experience, but it's generally a no no to date someone that will be evaluating you. The attendings evaluate the residents, you just don't date your attending.

 

[Pea-n-Me]

What type of situation would paddles be superior to patches? Just curious.

In most situations, pads are fine. But you never know what any given doctor will call for, so we have to have whatever might be needed (we are a major cardiac center). For instance, with a post op cardiac surgery patient, surgeons might call for internal paddles, etc.

 

[mickeymedic]

In most situations, pads are fine. But you never know what any given doctor will call for, so we have to have whatever might be needed (we are a major cardiac center). For instance, with a post op cardiac surgery patient, surgeons might call for internal paddles, etc.

That makes sense. The internal paddles never even crossed my mind. (The thought of trying to stick tiny sticky patches directly to the heart is cracking me up...but I'm weird like that.)

 

[Cool-Beans]

I'm pretty sure most hospitals still have paddles.

Since we're doing other peeves: Intubatinon as cure. Another thing I've seen done often. Especially on House. They are always and forever intubating people and then...no vent. The person is fine.

If you watched House, you'd figure that everyone was intubated and immediately extubated.

Grrr.

 

[PrincessKitty1]

For those of you who work in the hospitals...do your defibrillators still have paddles? Out on the ambulances we switched everything over to hands-free patches several years ago. I'm not even sure that paddles are an option on the newest monitors. On TV it seems that they are all still using paddles...I know it's more dramatic to straddle the patient, push the paddles against their chest and yell "CLEAR" than to slap some patches on and stand at a safe distance pushing a buttom.

No! We have patches on our defibrillators. The paddles on all the TV shows make me

What really gets me, though, is on Scrubs, the doctors are always doing things that IRL, only nurses do. Like 90% of what the doctors do on Scrubs in nursing care--starting IVs, giving IV meds, giving injections, placing catheters, etc. etc. And in the interviews with the producer/director/actors people always go on and on about how authentic the medical stuff is.

 

[Pea-n-Me]

Since we're doing other peeves

What about the way they put 02 tubing on? (Kind of wrapped around the whole head! )

 

[monkey68]

No! We have patches on our defibrillators. The paddles on all the TV shows make me

What really gets me, though, is on Scrubs, the doctors are always doing things that IRL, only nurses do. Like 90% of what the doctors do on Scrubs in nursing care--starting IVs, giving IV meds, giving injections, placing catheters, etc. etc. And in the interviews with the producer/director/actors people always go on and on about how authentic the medical stuff is.

Might be somewhat hospital dependent. The hospital I worked at in undergrad, the docs had to do a lot of the nursing stuff because there simply wasn't enough nurses, so it wasn't unheard of for the resident to be putting in an IV or administering medications. The thing is though, IMO, Scrubs is probably the most realistic medical show besides the TLC/Discovery Health shows.

 

[IWantMickey]

A favorite pet peeve was the Non rebreather not filled up.

As a former respiratory therapist, I would go nuts whenever I saw someone intubated, on a ventilator, and talking!

 

[npmommie]

LOL, now every time I'm pissed, I'm going to think, "Shock that asystole."

"Shock you!" "No, shock YOU!"

I'm also totally disgusted by the tv doctors that run from patient to patient without changing their gloves or washing their hands. Repulsive.

HA, I have seen them do it without washing hands, never without changing gloves, but I have seen a few in my day not wash hands in between
not so much lately, but in the past, yes.

Yeah, my husband refuses to watch medical dramas because he hates hearing me point out all the mistakes.


My hubby got peeved during one of the james bond movies when james was injecting himself with something to control an arrythmia and I went berserk on how WRONG that was.

I am forever yelling at the tv too........LOL......oh yeah, I was into that james bond movie, then when that scene happened I was

No! We have patches on our defibrillators. The paddles on all the TV shows make me

What really gets me, though, is on Scrubs, the doctors are always doing things that IRL, only nurses do. Like 90% of what the doctors do on Scrubs in nursing care--starting IVs, giving IV meds, giving injections, placing catheters, etc. etc. And in the interviews with the producer/director/actors people always go on and on about how authentic the medical stuff is.

the doctors on that show do what nurses in real life do because the nurses on that show don't exist, except for Carla, and all she seems to do is have time to talk to people all day.

Might be somewhat hospital dependent. The hospital I worked at in undergrad, the docs had to do a lot of the nursing stuff because there simply wasn't enough nurses, so it wasn't unheard of for the resident to be putting in an IV or administering medications. The thing is though, IMO, Scrubs is probably the most realistic medical show besides the TLC/Discovery Health shows.

I have worked at 2 large teaching hospitals and never once did I see a resident put in an IV or administer meds,so it must be hospital dependent.

 

[minniecarousel]

Ah, yes - I always got a kick out of them hanging the X-rays incorrectly (like upside-down!) They've gotten better over the years on that, though.

 

[monkey68]

Ah, yes - I always got a kick out of them hanging the X-rays incorrectly (like upside-down!) They've gotten better over the years on that, though.

The chest X-ray they put up in the opening credits of Scrubs is backwards. I didn't notice it until I started med school, and then I did some snooping on it. Supposedly, it was originally an inadvertent mistake, but they say it works well to show the confusion of being an intern/resident/attending that Scrubs is based on.

 

[TLSnell1981]

LOL, now every time I'm pissed, I'm going to think, "Shock that asystole."

"Shock you!" "No, shock YOU!"

Cool-Beans...I love how your mind works. You always come up with something off the wall.

 

[PrincessKitty1]

I have worked at 2 large teaching hospitals and never once did I see a resident put in an IV or administer meds,so it must be hospital dependent.

Although I have worked in many different settings, all my hospital experience is at a teaching hospital, and I haven't seen a resident put in an IV since very early in my career (mid 80s)--the docs would put in the IVs on the peds floors because the nurses were so understaffed and didn't have an hour to spend trying to stick a baby. These days, the nurses all put in the IVs, and if they can't get them in, they page an IV nurse. If the IV nurse can't get them in, they page the doctor. And then the doctor writes an order for a PICC line (although they will put in CVLs, but it's often an ARNP in the ICU putting in CVLs).

Meds? Never, in 24 years of nursing, have I seen a doctor give any meds other than in a code.Even when I refused to give meds a couple of times that I thought would harm a patient, and offered the physician the opportunity to give them if he/she so desired, he/she didn't give them.

When my father had back surgery in a community hospital, the neurosurgeon himself came in and got my dad out of bed the next morning--that's how understaffed that hospital was. So I guess I can imagine hospitals where physicians may insert IVs, but I am still having a hard time grasping the concept of a physician giving meds.