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

[monkey68]

Don't get me wrong when I said the doctors at the hospital I worked at gave meds, it wasn't an everyday occurence, but it wasn't unheard of either. Sometimes, it would be like, the patient needs the med, the nurses are all off doing other things, but the patient needs the med now, so the doc would just give it. It doesn't take long to administer it. This was an inner city hospital, where they notoriously were short staffed, to the point where they would let volunteers take vitals and draw blood just because it would otherwise never get done.

Course this was also about 4 or 5 years ago, things might have changed at that hospital since then. I also haven't seen it happening at any other hospital I've been to.

 

[Cool-Beans]

A friend of mine works for the VA and they have the residents doing it there.

 

[Disneylover79]

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".

It's crazy, I never actually realized just how many mistakes like that happen on TV shows until I started medical school. Now when I watch those shows, they make me want to pull my hair out, especially Grey's Anatomy.

Don't forget.... don't just assume it is asystole...could be the leads are just off... always check your leads...

 

[Disneylover79]

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

We had an inservice in the ICU about code survival rates on TV vs. code survival rates in real life. Seriuosly, an entire staff meeting and an agenda out forth to deal with peoples perceptions of codes vs. how they actually go and how we can help them cope with the mismatched ideas.

On TV you have something around an ~85% chance of surviving a code blue, the most shocked rhythm there is Asystole, and the person pretty much always comes back without any ill effects.

Real life: You have an 18% chance of surviving a code.... but only a 2% chance of actually surviving until discharge and not having major brain damage (minor imparments weren't counted). Most who code once will code again and pass away.

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.

And the patient's that are being "shocked" are not being ventilated... WHERE IS THE VENT.. I always yell that at the TV...

 

[Disneylover79]

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

This is absolutely great.... they did a great job.... and I never knew there where videos on medical stuff like that so now I am going to be on youtube forever...

 

[PrincessKitty1]

Also, codes last, like, 30 seconds on TV, and then they're over.

Don't get me started on McGuyver defibrillating someone with candlesticks he jerry-rigged to an electrical outlet. (1980s again)

The only medical show I watch is Scrubs--I don't want to see any SERIOUS hospital shows because they get me all stressed out as if I'm at work--so I have no opinion on how accurate the other shows might be.

Oh yeah, another thing on scrubs--I swear their "geriatric" patients all look about 55 or 60 years old. One floor I worked on had an average age of 83 (yes it was a floor specifically for geriatrics)--come on! I'm 52 and I'm not ready for everybody to shake their heads over me and say, "She had a good life, but it's time to let her go."

 

[teacups]

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

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

I love that!

 

[Disneylover79]

Depends on what channels you're watching



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



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.)



ITA




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.

Yes we still have paddles.... and we only use them with one DR when we cardiovert...but otherwise we use the pads

 

[scottishduffy]

I think my favorite medical silliness used to come from my soap opera.

I was watching one where they had a brain dead character. REPEAT: b-r-a-i-n d-e-a-d. Now, in the shows defense they did have a ventilator. You could see the bellows going up and down. However, all the patient had on was a little nasal cannula!. That was the most impressive little nasal cannula i've ever seen. I suppose you wouldn't want a big bulky tube and central lines interfering with the actors aesthetically pleasing face.

I used to love the medical scenes on the soap operas. Absolutely hysterical. I would love how people would just suddenly wake up from comas (never on a vent of course) and sit up right away to hug family then leave the hospital later that same episode.

Oh, and my hospital pretty much just uses the patches for the defibrillators. Unless you are cracking open a post-open heart patient and then we had the tiny paddles.

 

[Talking Hands]

TV is so unreal. On one they were saying the cochlear implant surgery is an out patient surgery. Geez. Don't think so. They're implanting some thing into the brain.
Plus you don't have the surgery and immediately come out hearing and understanding every sound and word.
TV is just giving people unreasonable expectations.

 

[Duckfan-in-Chicago]

Since we're throwing around pet peeves why are there so many medical shows and not one show in primetime about the fast-paced and sexually tense life of an in-house electrician???

 

[monkey68]

This is absolutely great.... they did a great job.... and I never knew there where videos on medical stuff like that so now I am going to be on youtube forever...

You should look up Amateur Transplants on youtube. For some reason, this is one of my favorites... http://www.youtube.com/watch?v=OGXn6HuCodE

 

[Cool-Beans]

Since we're throwing around pet peeves why are there so many medical shows and not one show in primetime about the fast-paced and sexually tense life of an in-house electrician???

I don't know! There should be!

 

[Disneylover79]

Depends on what channels you're watching



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



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.)



ITA




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 think my favorite medical silliness used to come from my soap opera.

I was watching one where they had a brain dead character. REPEAT: b-r-a-i-n d-e-a-d. Now, in the shows defense they did have a ventilator. You could see the bellows going up and down. However, all the patient had on was a little nasal cannula!. That was the most impressive little nasal cannula i've ever seen. I suppose you wouldn't want a big bulky tube and central lines interfering with the actors aesthetically pleasing face.

I used to love the medical scenes on the soap operas. Absolutely hysterical. I would love how people would just suddenly wake up from comas (never on a vent of course) and sit up right away to hug family then leave the hospital later that same episode.

Oh, and my hospital pretty much just uses the patches for the defibrillators. Unless you are cracking open a post-open heart patient and then we had the tiny paddles.

Exactly...... you hear the vent working...but there is only a NC in ....

 

[Handbag Lady]

Okay, hey THANKS everyone here for ruining every single future medical show I ever watch from here on out.



And for those of you going to Universal Studios ever in your future: ADR and Foley are NEVER recorded at the same time.



Take that! HA! HA-HA!

 

[PrincessKitty1]

Okay, hey THANKS everyone here for ruining every single future medical show I ever watch from here on out.



And for those of you going to Universal Studios ever in your future: ADR and Foley are NEVER recorded at the same time.



Take that! HA! HA-HA!

Geesh, thanks for spoiling Universal for me forever.

(Hey, as far as I'm concerned, when I see the word "Foley" I automatically think "catheter"....um, do you want to know that a Foley catheter is a device for urinary drainage?? )

 

[Cool-Beans]

And for those of you going to Universal Studios ever in your future: ADR and Foley are NEVER recorded at the same time.



Take that! HA! HA-HA!

I had to google that. In the event that you didn't know, in a hospital setting, a "foley" is the pee bag that most lay people refer to as a "catheter." Since there are so many different catheters, they all get their own name.

A whole bunch of healthcare people are going to read that and think, "What the hell. All I know in that sentence is 'foley.' What does she mean 'ADR and foley' and record what? I&O? Just what the hell is he talking about?!"

...and it won't ruin the show. I still enjoy the shows. If you just watch it for what it is, you'll still like it. Promise.

 

[Handbag Lady]

Geesh, thanks for spoiling Universal for me forever.

(Hey, as far as I'm concerned, when I see the word "Foley" I automatically think "catheter"....um, do you want to know that a Foley catheter is a device for urinary drainage?? )

Oh, where were you when I had the biggest crew of jerks in my past Foley crew? Really?

Can you buy one? Do you mean urinary drainage as in for anyone or just for males (I'm trying to get a picture with actually Googling it.

 

[Cool-Beans]

Oh, where were you when I had the biggest crew of jerks in my past Foley crew? Really?

Can you buy one? Do you mean urinary drainage as in for anyone or just for males (I'm trying to get a picture with actually Googling it.

Male or Female. The tube comes out of wherever you pee out of and drains into the pee bag.

 

[Handbag Lady]

I had to google that. In the event that you didn't know, in a hospital setting, a "foley" is the pee bag that most lay people refer to as a "catheter." Since there are so many different catheters, they all get their own name.

A whole bunch of healthcare people are going to read that and think, "What the hell. All I know in that sentence is 'foley.' What does she mean 'ADR and foley' and record what? I&O? Just what the hell is he talking about?!"

...and it won't ruin the show. I still enjoy the shows. If you just watch it for what it is, you'll still like it. Promise.

Isn't it funny, though? Why can't people in the movies and TV make anything realistic...even their OWN topic. You'd think they'd get it right. I can understand a movie-person getting medical terminology all wrong, but their own business?

Yes, ADR is done on one stage with one set-up and Foley is done on another one. Although, there are combo ADR/Foley stages but you never do them at the same time.


And I'm still dying that Foley is also a Pee-Bag.