Dr. Mark Posted March 24, 2014 Share Posted March 24, 2014 (edited) After being in the ER for 20+ years, you'd think you would have seen everthing. And you would be wrong. This weekend, I was treated to a whole new experience. Now, bear in mind, when you start CPR, you DO. NOT. STOP. Not for anything, until the patient is either revived, or the code is called, and the patient is pronounced. In the last few years, with the development of smaller and smaller microchips, and better, MUCH more powerful batteries, a new type of pacemaker has been developed, called the AICD: The Automatic Implantable Cardiac Defibrillator. It is used in people who have certain types of persistent ventricular cardiac arrythmias. If the person it's in goes into a potentially fatal arrythmia, like ventricular fibrillation or V tach, it pops them with an electric charge, just like in the movies or on TV when you see a "Code", and they put the paddles on someones chest and shock them? Same principle. Well, this weekend, I got to get all up close and personal with one. They brought in a patient who had collapsed, and had one of these devices. the patient went into cardiac arrest, and I was the one who started CPR. I had gotten them intubated, already, so their airway was secure, and the nurses were trying to get the monitors hooked up, get IV's in, get code drugs pushed, all that, so I started chest compressions. Well, if you are doing CPR right, the monitor looks just like ventricular tachycardia. I had gloves on, but the metal band of my wristwatch and the inside of my wrist were in contact with the patients skin, and I was leaning into the bed, with nothing between my thigh and the metal bed rail but scrub pants which are about the thickness of gauze. . Well, the little electronic microchip brain in the AICD looked at the rythmn it was seeing from my chest compressions, and decided that the patient was in V tach, and needed to be shocked. Four times. In quick succession. It was like being hit in the chest with a Louisville slugger by Mark McGwire or Barry Bonds. Four times. The AICD was obviously set on it's highest shock setting, because the patient bounced on the bed when the charge was applied. I did not bounce. I jerked and screamed like a little bitch. The nurses found this to be quite hilarious. Defibrillator: BANG! Me: "What the hell..." Defibrillator: BANG! Me: "SHIT! The damn defibrillator is firing!..get me..." Defibrillator: BANG! Me: "AARGH! FUCK! GET ME A HANDFUL OF GLOVES TO PUT ON THE CHEST!" Defibrillator: BANG! Me: "High-pitched screechy yodeling noises!" The nurses were all laughing so hard, tears were running down their faces. Sometimes, I hate my nurses. Edited March 24, 2014 by Dr. Mark 6 Quote Link to comment Share on other sites More sharing options...
Prof. O Posted March 24, 2014 Share Posted March 24, 2014 Great story to start the day. Such a shocking experience - LOL. Quote Link to comment Share on other sites More sharing options...
XV62 Posted March 24, 2014 Share Posted March 24, 2014 Pussy...................... 4 Quote Link to comment Share on other sites More sharing options...
hasbin Posted March 24, 2014 Share Posted March 24, 2014 I'm shocked... No make that, "your shocked" Quote Link to comment Share on other sites More sharing options...
SwissIndian Posted March 24, 2014 Share Posted March 24, 2014 No photos ? Quote Link to comment Share on other sites More sharing options...
BONMYI Posted March 24, 2014 Share Posted March 24, 2014 (edited) I don't know much about those things but, somehow we seen that coming ! ! Aren't they tagged or, wear some kinda of ID ! ? I can see where visually, the nurses found that funny.. Your a good man Doc., it's gotta be difficult enough to do your job with err without being entertaining too.. Thanks for sharing, Dave Edited March 24, 2014 by BONMYI Quote Link to comment Share on other sites More sharing options...
injuncowboy Posted March 24, 2014 Share Posted March 24, 2014 You got a new road name. Sparky! Quote Link to comment Share on other sites More sharing options...
meinekemike1 Posted March 24, 2014 Share Posted March 24, 2014 Doc did the dude live? Quote Link to comment Share on other sites More sharing options...
Brock Posted March 24, 2014 Share Posted March 24, 2014 you got them back i am sure when they cleaned up the piss from the floor under you. 1 Quote Link to comment Share on other sites More sharing options...
Dr. Mark Posted March 24, 2014 Author Share Posted March 24, 2014 Pussy...................... Robin, the next time I see you, I am going to hand you the end of an extension cord that I have stripped the end off of, and then plug it in. No photos ? Woody, my nurses would love you. You will fit right in. Doc did the dude live? Sadly, no. But jeez, the patient was well into their 80's, so, you know. We tried. Boy did we. you got them back i am sure when they cleaned up the piss from the floor under you. Are you and Woody related? 1 Quote Link to comment Share on other sites More sharing options...
XV62 Posted March 24, 2014 Share Posted March 24, 2014 Doc, I wadn't talking about getting shocked, just whining about your nurses................................ Quote Link to comment Share on other sites More sharing options...
gtrjoe Posted March 24, 2014 Share Posted March 24, 2014 Actual pics of event here .... http://www.i-mockery.com/minimocks/chopping-mall/chopping-mall18.gif 1 Quote Link to comment Share on other sites More sharing options...
Tahoe Chief Posted March 24, 2014 Share Posted March 24, 2014 Insert video from the movie Home Alone, where the guy grabs the faucet handles and squeals like a bitch. 1 Quote Link to comment Share on other sites More sharing options...
indian T Posted March 24, 2014 Share Posted March 24, 2014 it's probably gonna be decaf for the rest of the day, huh Doc? 1 Quote Link to comment Share on other sites More sharing options...
Maldev Posted March 24, 2014 Share Posted March 24, 2014 Doc, One of my friends has one of those implanted and after a few weeks off exercising per doc's orders, he went back to the treadmill. Apparently his exercise routine got his heart rate above what it should have been and the pacemaker went off and jolted him off the treadmill and into the one behind him where it shocked him three more times. Turns out the setting on the pacemaker was set way too low for him and that was the first time he hit the limiter. Said the same as you...like getting hit with a baseball bat right in the chest. Quote Link to comment Share on other sites More sharing options...
Dr. Mark Posted March 24, 2014 Author Share Posted March 24, 2014 Doc, One of my friends has one of those implanted and after a few weeks off exercising per doc's orders, he went back to the treadmill. Apparently his exercise routine got his heart rate above what it should have been and the pacemaker went off and jolted him off the treadmill and into the one behind him where it shocked him three more times. Turns out the setting on the pacemaker was set way too low for him and that was the first time he hit the limiter. Said the same as you...like getting hit with a baseball bat right in the chest. Yeah. Now I know how the "Don't tase me, Bro" guy feels. 1 Quote Link to comment Share on other sites More sharing options...
CHIEF DOC 99 Posted March 24, 2014 Share Posted March 24, 2014 I heard Kelly sports a new generation ThunderHeart defibin pacemaker nowadays. What is the HepC patient CPR protocol nowadays? Quote Link to comment Share on other sites More sharing options...
injun46 Posted March 24, 2014 Share Posted March 24, 2014 That reminds me of the time my little brother peed on the electric fence. Quote Link to comment Share on other sites More sharing options...
CKelly Posted March 25, 2014 Share Posted March 25, 2014 I heard Kelly sports a new generation ThunderHeart defibin pacemaker nowadays. What is the HepC patient CPR protocol nowadays? I just hope it works as good as the old one did. It's almost like the Gilroys and SL 1 Quote Link to comment Share on other sites More sharing options...
CKelly Posted March 25, 2014 Share Posted March 25, 2014 After being in the ER for 20+ years, you'd think you would have seen everthing. And you would be wrong. This weekend, I was treated to a whole new experience. Now, bear in mind, when you start CPR, you DO. NOT. STOP. Not for anything, until the patient is either revived, or the code is called, and the patient is pronounced. In the last few years, with the development of smaller and smaller microchips, and better, MUCH more powerful batteries, a new type of pacemaker has been developed, called the AICD: The Automatic Implantable Cardiac Defibrillator. It is used in people who have certain types of persistent ventricular cardiac arrythmias. If the person it's in goes into a potentially fatal arrythmia, like ventricular fibrillation or V tach, it pops them with an electric charge, just like in the movies or on TV when you see a "Code", and they put the paddles on someones chest and shock them? Same principle. Well, this weekend, I got to get all up close and personal with one. They brought in a patient who had collapsed, and had one of these devices. the patient went into cardiac arrest, and I was the one who started CPR. I had gotten them intubated, already, so their airway was secure, and the nurses were trying to get the monitors hooked up, get IV's in, get code drugs pushed, all that, so I started chest compressions. Well, if you are doing CPR right, the monitor looks just like ventricular tachycardia. I had gloves on, but the metal band of my wristwatch and the inside of my wrist were in contact with the patients skin, and I was leaning into the bed, with nothing between my thigh and the metal bed rail but scrub pants which are about the thickness of gauze. . Well, the little electronic microchip brain in the AICD looked at the rythmn it was seeing from my chest compressions, and decided that the patient was in V tach, and needed to be shocked. Four times. In quick succession. It was like being hit in the chest with a Louisville slugger by Mark McGwire or Barry Bonds. Four times. The AICD was obviously set on it's highest shock setting, because the patient bounced on the bed when the charge was applied. I did not bounce. I jerked and screamed like a little bitch. The nurses found this to be quite hilarious. Defibrillator: BANG! Me: "What the hell..." Defibrillator: BANG! Me: "SHIT! The damn defibrillator is firing!..get me..." Defibrillator: BANG! Me: "AARGH! FUCK! GET ME A HANDFUL OF GLOVES TO PUT ON THE CHEST!" Defibrillator: BANG! Me: "High-pitched screechy yodeling noises!" The nurses were all laughing so hard, tears were running down their faces. Sometimes, I hate my nurses. You should try being on the other side. I've gotten hit couple of times. Why didn't you turn it off? I know every time they work on me they turn it off. For just that reason and so they don't cut something off by mistake. Quote Link to comment Share on other sites More sharing options...
lschultz Posted March 25, 2014 Share Posted March 25, 2014 you got them back i am sure when they cleaned up the piss from the floor under you. Doc had his depends on so no water on floor. If it would of been a wet floor Quote Link to comment Share on other sites More sharing options...
Dr. Mark Posted March 25, 2014 Author Share Posted March 25, 2014 You should try being on the other side. I've gotten hit couple of times. Why didn't you turn it off? I know every time they work on me they turn it off. For just that reason and so they don't cut something off by mistake. Well, duh. Now why didn't I think of that? 1. Because some dipshit had taken the ring magnet device that you use to turn them off out of the code cart. I couldn't turn it off. 2. Until it discharges, or someone who knows it's an AICD and not a normal pacemaker TELLS us that it's an implanted defibrillator, we don't know. It looks exactly like a regular pacer from the outside. I can't see through skin. Quote Link to comment Share on other sites More sharing options...
mycorn Posted March 25, 2014 Share Posted March 25, 2014 if you'd have looked down i bet you coulda read the serial # when yall were stuck together ....'coarse it's a little late then i had to ask the tech 3 different ways to get him to tell me pop's st jude was just a clock Quote Link to comment Share on other sites More sharing options...
Wildhorse Posted March 25, 2014 Share Posted March 25, 2014 Shocking news, Doc. Quote Link to comment Share on other sites More sharing options...
TNSilverScout Posted March 27, 2014 Share Posted March 27, 2014 Damn. That could've put your heat rythum at risk. Quote Link to comment Share on other sites More sharing options...
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