Typical view of defibrillation in progress, with the operator at the head, but clear of contact with the patient

Defibrillation is the definitive treatment for the life-threatening cardiac arrhythmias ventricular fibrillation and pulseless ventricular tachycardia. Defibrillation consists of delivering a therapeutic dose of electrical energy to the affected heart with a device called a defibrillator. This depolarizes a critical mass of the heart muscle, terminates the arrhythmia, and allows normal sinus rhythm to be reestablished by the body's natural pacemaker, in the sinoatrial node of the heart. Download high resolution version (500x697, 66 KB) File links The following pages link to this file: Cardiopulmonary resuscitation Paramedic Defibrillation Artificial respiration Mechanical ventilation SMUR Public access defibrillation User:Rama/firstaid drawings ... Download high resolution version (500x697, 66 KB) File links The following pages link to this file: Cardiopulmonary resuscitation Paramedic Defibrillation Artificial respiration Mechanical ventilation SMUR Public access defibrillation User:Rama/firstaid drawings ... Ventricular fibrillation (V-fib or VF) is a cardiac condition which consists of a lack of coordination of the contraction of the muscle tissue of the large chambers of the heart that eventually leads to the heart stopping altogether. ... Ventricular tachycardia (V-tach or VT) is a fast rhythm that originates in one of the ventricles of the heart. ... The normal electrical conduction in the heart allows the impulse that is generated by the SA node of the heart to be propagated to (and stimulate) the myocardium (muscle of the heart). ... The contractions of the heart are controlled by electrical impulses, these fire at a rate which controls the beat of the heart. ... The sinoAtrial node (abbreviated SA node or SAN, also called the sinus node) is the impulse generating (pacemaker) tissue located in the right atrium of the heart, and thus the generator of sinus rhythm. ...

Defibrillators can be external, transvenous, or implanted, depending on the type of device used. Some external units, known as automated external defibrillators (AEDs), automate the diagnosis of treatable rhythms, meaning that lay responders or bystanders are able to use them successfully with little, or in some cases no, training. An automated external defibrillator, open and ready for pads to be attached An Automated External Defibrillator or AED is a portable electronic device that automatically diagnoses the potentially life threatening cardiac arrhythmias of ventricular fibrillation and ventricular tachycardia in a patient,[1] and is able to treat them by application...

History

Defibrillation was first demonstrated in 1899 by Prevost and Batelli, two physiologists from University of Geneva, Switzerland. They discovered that small electric shocks could induce ventricular fibrillation in dogs, and that larger charges would reverse the condition. Wikipedia does not yet have an article with this exact name. ... The University of Geneva (Université de Genève) is a university in Geneva, Switzerland. ...

The first use on a human was in 1947 by Claude Beck,^[1] professor of surgery at Western Reserve University. Beck's theory was that ventricular fibrillation often occurred in hearts which were fundamentally healthy, in his terms "Heart too good to die", and that there must be a way of saving them. Beck first used the technique successfully on a 14 year old boy who was being operated on for a congenital chest defect. The boy's chest was surgically opened, and manual cardiac massage was undertaken for 45 minutes until the arrival of the defibrillator. Beck used internal paddles either side of the heart, along with procaine amide, a heart drug, and achieved return of normal sinus rhythm. The normal electrical conduction in the heart allows the impulse that is generated by the SA node of the heart to be propagated to (and stimulate) the myocardium (muscle of the heart). ...

These early defibrillators used the alternating current from a power socket, transformed from the 110-240 volts available in the line, up to between 300 and 1000 volts, to the exposed heart by way of 'paddle' type electrodes. The technique was often ineffective in reverting VF while morphological studies showed damage to the cells of the heart muscle post mortem. The nature of the AC machine with a large transformer also made these units very hard to transport, and they tended to be large units on wheels.

Closed-chest method

Until the early 1950s, defibrillation of the heart was possible only when the chest cavity was open during surgery. The technique used an alternating current from a 300 or greater volts source delivered to the sides of the exposed heart by 'paddle' electrodes where each electrode was a flat or slightly concave metal plate of about 40 mm diameter. The closed-chest defibrillator device which applied an alternating current of greater than 1000 volts, conducted by means of externally applied electrodes through the chest cage to the heart, was pioneered by Dr V. Eskin with assistance by A. Klimov in Frunze, USSR in mid 1950s.^[2] City lights viewed in a motion blurred exposure. ... The volt is the SI derived unit for electric potential and voltage (derived from the ampere and watt). ...

Move to Direct Current

A circuit diagram showing the simplest (non-electronically controlled) defibrillator design, depending on the inductor ( damping ), producing a Lown, Edmark or Gurvich Waveform

In 1959 Bernard Lown commenced research into an alternative technique which involved charging of a bank of capacitors to approximately 1000 Volts with an energy content of 100-200 Joules then delivering the charge through an inductance such as to produce a heavily damped sinusoidal wave of finite duration (~5 milliseconds) to the heart by way of 'paddle' electrodes. The work of Lown was taken to clinical application by engineer Barouh Berkovits with his "cardioverter". Image File history File links Defrib. ... Image File history File links Defrib. ... Bernard Lown, M.D. was the original developer of the defibrillator and is an internationally known peace activist. ... See Capacitor (component) for a discussion of specific types. ... One millisecond is one-thousandth of a second. ... Barouh Berkovits is one of the pioneers of Bio-engineering; particularly the cardiac defibrillator and artificial cardiac pacemaker. ...

The Lown waveform, as it was known, was the standard for defibrillation until the late 1980s when numerous studies showed that a biphasic truncated waveform (BTE) was equally efficacious while requiring the delivery of lower levels of energy to produce defibrillation. A side effect was a significant reduction in weight of the machine. The BTE waveform, combined with automatic measurement of transthoracic impedance is the basis for modern defibrillators.

Portable units become available

A major breakthrough was the introduction of portable defibrillators in ambulances. This was pioneered in the early 1960s by Prof. Frank Pantridge in Belfast. Today portable defibrillators are one of the most important tools carried by ambulances. They are the only proven way to resuscitate a person who has had a cardiac arrest unwitnessed by EMS who is still in persistent ventricular fibrillation or ventricular tachycardia at the arrival of pre-hospital providers. An ambulance in San Jose del Cabo, Mexico A Helicopter used as an Ambulance. ... James Francis Frank Pantridge (October 3, 1916, Hillsborough – 26 December 2004) was a Northern Ireland physician and cardiologist who transformed emergency medicine and paramedic services with the invention of the portable defibrillator. ... This article is about the city in Northern Ireland. ...

Gradual improvements in the design of defibrillators, and partly based on the work developing implanted versions (see below) have lead to the availability of Automated External Defibrillators, which can analyse the heart rhythm by themselves, diagnosing the shockable rhythms, and then charging to treat. This means that no clinical skill is required in their use, allowing lay people to respond to emergencies effectively.

Change to a biphasic waveform

Until the late 1980s, external defibrillators delivered a Lown type waveform (see Bernard Lown) which was a heavily damped sinusoidal impulse having a mainly uniphasic characteristic. Biphasic defibrillation, however, alternates the direction of the pulses, completing one cycle in approximately 10 milliseconds. Biphasic defibrillation was originally developed and used for implantable cardioverter-defibrillators. When applied to external defibrillators, biphasic defibrillation significantly decreases the energy level necessary for successful defibrillation. This, in turn, decreases risk of burns and myocardial damage.
Ventricular fibrillation (VF) could be returned to normal sinus rhythm in 60% of cardiac arrest patients treated with a single shock from a monophasic defibrillator. Most biphasic defibrillators have a first shock success rate of greater than 90%.^[3] Bernard Lown, M.D. was the original developer of the defibrillator and is an internationally known peace activist. ... In mathematics, the trigonometric functions are functions of an angle, important when studying triangles and modeling periodic phenomena. ... The normal electrical conduction in the heart allows the impulse that is generated by the SA node of the heart to be propagated to (and stimulate) the myocardium (muscle of the heart). ...

Implantable devices

A further development in defibrillation came with the invention of the implantable device, known as an implantable cardioverter-defibrillator (or ICD). This was pioneered at Sinai Hospital in Baltimore by a team including Stephen Heilman, Alois Langer, Morton Mower, Michel Mirowski, and Mir Imran, with the help of industrial collaborator Intec Systems of Pittsburgh. Mirowski teamed up with Mower and Staewen, and together they commenced their research in 1969 but it was 11 years before they treated their first patient. Similar developmental work was carried out by Schuder and colleagues at the University of Missouri. ICD An implantable cardioverter-defibrillator (ICD), also known as an automated implantable cardioverter-defibrillator (AICD), is a small battery powered electrical impulse generator which is implanted in patients who are at risk of sudden cardiac death due to ventricular fibrillation. ... Sinai Hospital is a Baltimore, Maryland hospital originally founded in 1866 as the Hebrew Hospital and Asylum. ... Flag Seal Nickname: Monument City, Charm City, Mob Town, B-more Motto: Get In On It (formerly The City That Reads and The Greatest City in America; BELIEVE is not the official motto but rather a specific campaign) Location Location of Baltimore in Maryland Coordinates , Government Country State County United... Dr. Mieczyslaw (Michel) Mirowski (1924 - 1990) was born in Warsaw, Poland. ... Mir Imran is a prolific entrepreneur and venture capitalist, with a long track record of success in medical technology. ... This article is about the university in Columbia. ...

The work was commenced, despite doubts amongst leading experts in the field of arrhythmias and sudden death. There was doubt that their ideas would ever become a clinical reality. In 1972 Bernard Lown, the inventor of the external defibrillator, stated in the journal Circulation - "The very rare patient who has frequent bouts of ventricular fibrillation is best treated in a coronary care unit and is better served by an effective antiarrhythmic program or surgical correction of inadequate coronary blood flow or ventricular malfunction. In fact, the implanted defibrillator system represents an imperfect solution in search of a plausible and practical application." Bernard Lown, M.D. was the original developer of the defibrillator and is an internationally known peace activist. ... Circulation is a scientific journal published by the American Heart Association. ...

The problems to be overcome were the design of a system which would allow detection of ventricular fibrillation or ventricular tachycardia. Despite the lack of financial backing and grants, they persisted and the first device was implanted in February 1980 at Johns Hopkins Hospital by Dr. Levi Watkins, Jr. Modern ICDs do not require a thoracotomy and possess pacing, cardioversion, and defibrillation capabilities. The Dome of the Johns Hopkins Hospital as seen from Broadway. ... Thoracotomy is a surgical incision into the chest. ...

The invention of implantable units is invaluable to some regular sufferers of heart problems, although they are generally only given to those people who have already had a cardiac episode.

Types

Manual external defibrillator

External defibrillator / monitor

The units are used in conjunction with (or more often have inbuilt) electrocardiogram readers, which the clinician uses to diagnose a cardiac condition (most often fibrillation or tachycardia although there are some other rhythms which can be treated by different shocks). The clinician will then decide what charge (voltage) to use, based on their prior knowledge and experience, and will deliver the shock through paddles or pads on the patient's chest. As they require detailed medical knowledge, these units are generally only found in hospitals and on some ambulances. For instance, every NHS ambulance in the United Kingdom is equipped with a manual defibrillator for use by the attending Paramedics and Technicians. In the United States, all Paramedics are trained to recognize rhythms using 3-lead and 12-lead systems, and deliver appropriate therapies with manual defibrilators. It has become a basic standard of care for a manual defibrilator to be carried on US Advanced Life Support ambulances. Image File history File linksMetadata Download high resolution version (1600x1200, 702 KB) Beschreibung Description: A defibrillator/monitor/pacer from an ambulance in Graz, Austria. ... Image File history File linksMetadata Download high resolution version (1600x1200, 702 KB) Beschreibung Description: A defibrillator/monitor/pacer from an ambulance in Graz, Austria. ... “QRS” redirects here. ... For the town in the Republic of Ireland, see Hospital, County Limerick. ... An ambulance in San Jose del Cabo, Mexico A Helicopter used as an Ambulance. ... The National Health Service (NHS) is the publicly-funded healthcare system of the United Kingdom. ... Typical view of the defibrillator operator. ...

Manual internal defibrillator

These are the direct descendants of the work of Beck and Lown. They are virtually identical to the external version, except that the charge is delivered through internal paddles in direct contact with the heart. These are almost exclusively found in operating theatres, where the chest is likely to be open, or can be opened quickly by a surgeon.

Automated external defibrillator (AED)

Main article: Automated external defibrillator

An AED at a railway station in Japan. The AED box has information on how to use it in Japanese, English, Chinese and Korean, and station staff are trained to use it.

These simple to use units are based on computer technology which is designed to analyze the heart rhythm itself, and then advise whether a shock is required. They are designed to be used by lay persons, who require little training. They are usually limited in their interventions to delivering high joule shocks for VF and VT rhythms, making them generally limiting for use by health professionals, who could diagnose and treat a wider range of problems with a manual or semi-automatic unit. An automated external defibrillator, open and ready for pads to be attached An Automated External Defibrillator or AED is a portable electronic device that automatically diagnoses the potentially life threatening cardiac arrhythmias of ventricular fibrillation and ventricular tachycardia in a patient,[1] and is able to treat them by application... Image File history File links Download high-resolution version (600x800, 81 KB) 駅などに設置されはじめたAED 撮影日：2006年 8月11日 撮影地：東急大井町線大井町駅（東京都品川区大井） 撮影者：cory AED is setting up on some railway station in Japan. ... Image File history File links Download high-resolution version (600x800, 81 KB) 駅などに設置されはじめたAED 撮影日：2006年 8月11日 撮影地：東急大井町線大井町駅（東京都品川区大井） 撮影者：cory AED is setting up on some railway station in Japan. ... The delivery of modern health care depends on an expanding group of highly trained professionals coming together as an interdisciplinary team. ...

The automatic units also take time (generally 10-20 seconds) to diagnose the rhythm, where a professional could diagnose and treat the condition far quicker with a manual unit.^{[citation needed]} These time intervals for analysis, which require stopping chest compressions, have been shown in a number of studies to have a significant negative effect on shock success.^{[citation needed]} This effect led to the recent change in the AHA defibrillation guideline (calling for two minutes of CPR after each shock without analyzing the cardiac rhythm) and a statement in the ACLS Provider Manual that AEDs should not be used when manual defibrillators and trained operators are available.^{[citation needed]}

Automated external defibrillators are generally either held by trained personnel who will attend incidents, or are public access units which can be found in places including corporate and government offices, shopping centres, airports, restaurants, casinos, hotels, sports stadiums, schools and universities, community centres, fitness centres and health clubs. This article includes a list of works cited or a list of external links, but its sources remain unclear because it lacks in-text citations. ... For the traditional meaning of the word mall, see mall. ... For other uses, see Restaurant (disambiguation). ... This article or section does not adequately cite its references or sources. ... For other uses, see Hotel (disambiguation). ... The Athens Olympic Stadium Typical stadium seating consists of terraces, such as shown here at Sarajevos Stadium Kosevo. ... Students in Rome, Italy. ... The University of Cambridge is an institute of higher learning. ...

An automated external defibrillator, open and ready for pads to be attached

The locating of a public access AED should take in to account where large groups of people gather, and the risk category associated with these people, to ascertain whether the risk of a sudden cardiac arrest incident is high. For example, a centre for teenage children is a particularly low risk category (as children very rarely enter heart rhythms such as VF or VT, being generally young and fit, and the most common cause of paediatric cardiac arrest is trauma - where the heart is more likely to enter asystole or PEA, where an AED is no use), whereas a large office building with a high ratio of males over 50 is a very high risk environment. Image File history File links Metadata Size of this preview: 450 × 600 pixelsFull resolution (1728 × 2304 pixel, file size: 783 KB, MIME type: image/jpeg) File history Legend: (cur) = this is the current file, (del) = delete this old version, (rev) = revert to this old version. ... Image File history File links Metadata Size of this preview: 450 × 600 pixelsFull resolution (1728 × 2304 pixel, file size: 783 KB, MIME type: image/jpeg) File history Legend: (cur) = this is the current file, (del) = delete this old version, (rev) = revert to this old version. ...

In many areas, emergency services vehicles are likely to carry AEDs, with some Ambulances carrying an AED in addition to a manual unit. In addition, some police or fire service vehicles carry an AED for first responder use. Some areas have dedicated community first responders, who are volunteers tasking with keeping an AED and taking it to any victims in their area. It is also increasingly common to find AEDs on transport such as commercial airlines and cruise ships. First responder is a term used by national authorities for local law enforcement, local Emergency Medical Technicians (EMTs), local firemen and fire rescue. ...

In order to make them highly visible, public access AEDs often are brightly coloured, and are mounted in protective cases near the entrance of a building. When these protective cases are opened, and the defibrillator removed, some will sound a buzzer to alert nearby staff to their removal but do not necessarily summon emergency services. All trained AED operators should also know to phone for an ambulance when sending for or using an AED, as the patient will be unconscious, which always requires ambulance attendance.

Semi-automated external defibrillators

These units are a compromise between a full manual unit and an automated unit. They are mostly used by pre-hospital care professionals such as paramedics and emergency medical technicians. These units have the automated capabilities of the AED but also feature an ECG display, and a manual override, where the clinician can make their own decision, either before or instead of the computer. Some of these units are also able to act as a pacemaker if the heart rate is too slow (bradycardia) and perform other functions which require a skilled operator. The Star of Life, a globally recognised symbol for emergency medical services A paramedic is a medical professional, usually a member of the emergency medical service, who responds to medical and trauma emergencies in the pre-hospital environment, provides emergency treatment and, when appropriate, transports a patient to definitive care... The Star of Life, a global symbol for medical service EMTs loading an injured skier into an ambulance An Emergency Medical Technician (EMT) is an emergency responder trained to provide emergency medical services to the critically ill and injured. ... A pacemaker, scale in centimeters A pacemaker (or artificial pacemaker, so as not to be confused with the hearts natural pacemaker) is a medical device which uses electrical impulses, delivered by electrodes contacting the heart muscles, to regulate the beating of the heart. ... Bradycardia, as applied to adult medicine, is defined as a resting heart rate of under 60 beats per minute, though it is seldom symptomatic until the rate drops below 50 beat/min. ...

Implantable Cardioverter-Defibrillator (ICD)

Main article: Implantable cardioverter-defibrillator

Also known as Automatic Internal Cardiac Defibrillator (AICD). These devices are implants, similar to pacemakers (and many can also perform the pacemaking function). They constantly monitor the patient's heart rhythm, and automatically administer shocks for various life threatening arrhythmias, according to the device's programming. Many modern devices can distinguish between ventricular fibrillation, ventricular tachycardia, and more benign arrhythmias like supraventricular tachycardia and atrial fibrillation. Some devices may attempt overdrive pacing prior to synchronised cardioversion. When the life threatening arrhythmia is ventricular fibrillation, the device is programmed to proceed immediately to an unsynchronized shock. ICD An implantable cardioverter-defibrillator (ICD), also known as an automated implantable cardioverter-defibrillator (AICD), is a small battery powered electrical impulse generator which is implanted in patients who are at risk of sudden cardiac death due to ventricular fibrillation. ... A pacemaker, scale in centimeters A pacemaker (or artificial pacemaker, so as not to be confused with the hearts natural pacemaker) is a medical device which uses electrical impulses, delivered by electrodes contacting the heart muscles, to regulate the beating of the heart. ... Ventricular fibrillation (V-fib or VF) is a cardiac condition which consists of a lack of coordination of the contraction of the muscle tissue of the large chambers of the heart that eventually leads to the heart stopping altogether. ... Ventricular tachycardia (V-tach or VT) is a fast rhythm that originates in one of the ventricles of the heart. ... A supraventricular tachycardia (SVT) is a rapid rhythm of the heart in which the origin of the electrical signal is either the atria or the AV node. ... Atrial fibrillation (AF or afib) is a cardiac arrhythmia (abnormal heart rhythm) that involves the two upper chambers (atria) of the heart. ...

There are cases where the patient's ICD may fire constantly or inappropriately This is considered a medical emergency, as it depletes the device's battery life, causes significant discomfort and anxiety to the patient, and in some cases may actually trigger life threatening arrhythmias. Some emergency medical services personnel are now equipped with a ring magnet to place over the device, which effectively disables the shock function of the device while still allowing the pacemaker to function (if the device is so equipped). If the device is shocking frequently, but appropriately, EMS personnel may administer sedation. {{Otheruses4|the medical term|the Australian television series|Medical Emergenc an immediate threat to a persons life or long term health. ... An Emergency medical service (abbreviated to initialism EMS in many countries) is a service providing out-of-hospital acute care and transport to definitive care, to patients with illnesses and injuries which the patient believes constitutes a medical emergency. ... For other uses, see Magnet (disambiguation). ...

Interface with the patient

The most well-known type of electrode is the traditional metal paddle with an insulated handle. This type must be held in place on the patient's skin while a shock or a series of shocks is delivered. Before the paddle is used, a gel must be applied to the patient's skin, in order to ensure a good connection and to minimize electrical resistance, also called chest impedance (despite the DC discharge). These are generally only found on the manual external units. Electrical resistance is a measure of the degree to which an electrical component opposes the passage of current. ...

Another type of resuscitation electrode is designed as an adhesive pad. When a patient has been admitted due to heart problems, and the physician or nurse has determined that he or she is at risk of arrhythmia, they may apply adhesive electrodes to the patient in anticipation of any problems that may arise. These electrodes are left connected to a defibrillator. If defibrillation is required, the machine is charged, and the shock is delivered, without any need to apply any gel or to retrieve and place any paddles. These adhesive pads are found on most automated and semi-automated units. A cardiac arrhythmia, also called cardiac dysrhythmia, is a disturbance in the regular rhythm of the heartbeat. ...

Both solid- and wet-gel adhesive electrodes are available. Solid-gel electrodes are more convenient, because there is no need to clean the patient's skin after removing the electrodes. However, the use of solid-gel electrodes presents a higher risk of burns during defibrillation, since wet-gel electrodes more evenly conduct electricity into the body.

Adhesive electrodes are designed to be used not only for defibrillation, but also for non-invasive pacing and electrical cardioversion. Through electricity or drug therapy, cardioversion converts heart arrhythmias to normal rhythms. ...

While the paddles on a Monitor/Defibrillator may be quicker than using the patches, adhesive patches are superior due to their ability to provide appropriate EKG tracing without the artifact visible from human interference with the paddles. Adhesive electrodes are also inherently safer than the paddles for the operator of the defibrillator to use, as they minimize the risk of the operator coming into physical (and thus electrical) contact with the patient as the shock is delivered, by allowing the operator to stand several feet away. Another inconvenience of the paddles is the requirement of around 25lbs of pressure to be applied while defibrillating. ECG may also refer to the East Coast Greenway Lead II An Electrocardiogram (ECG or EKG, abbreviated from the German Elektrokardiogramm) is a graphic produced by an electrocardiograph, which records the electrical voltage in the heart in the form of a continuous strip graph. ... In natural science and signal processing, an artifact is any perceived distortion or other data error caused by the instrument of observation. ...

Placement

Anterio-apical placement of external defibrillator electrodes (When defibrillation is unsuccessful, anterio-posterior placement is also sometimes attempted)

Resuscitation electrodes are placed according to one of two schemes. The anterior-posterior scheme (conf. image) is the preferred scheme for long-term electrode placement. One electrode is placed over the left precordium (the lower part of the chest, in front of the heart). The other electrode is placed on the back, behind the heart in the region between the scapula. This placement is preferred because it is best for non-invasive pacing. Image File history File links No higher resolution available. ... Image File history File links No higher resolution available. ...

The anterior-apex scheme can be used when the anterior-posterior scheme is inconvenient or unnecessary. In this scheme, the anterior electrode is placed on the right, below the clavicle. The apex electrode is applied to the left side of the patient, just below and to the left of the pectoral muscle. This scheme works well for defibrillation and cardioversion, as well as for monitoring an ECG.

Popular culture references

Trivia sections are discouraged under Wikipedia guidelines. The article could be improved by integrating relevant items and removing inappropriate ones.

The defibrillator was first seen on film in the 1966 movie Fantastic Voyage. Since then they have appeared in many modern television and film medical programs. Its use in the near-death experience experiments by the characters of the 1990 movie Flatliners made the defibrillator virtually one of the co-stars of that film. It was also utilized in plotlines in several films and TV series. Image File history File links Broom_icon. ... This article does not cite any references or sources. ... Flatliners is a 1990 movie starring Kiefer Sutherland, Julia Roberts, Kevin Bacon, William Baldwin and Oliver Platt as medical students experimenting with near-death experiences. ...

In the television series Emergency!, firefighters John Gage and Roy DeSoto often used defibrillators, with their 'catchphrase' being the standard warning (still used to this day) of yelling "Clear!" right before applying the shock, to warn everyone around to stay away from the patient for risk of electrical shock. Emergency! was a popular crime drama/medical television series that was produced by Mark VII Limited (Jack Webbs company) and distributed by Universal Studios. ...

In the same series, the defibrillator induces a sudden, violent jerk or convulsion by the patient; in reality, although the muscles may contract, such dramatic patient presentation is rare.

Most television shows will have the medical provider defibrillate the "flat-line" ECG rhythm (also known as asystole); this is not done in real life. Only the cardiac arrest rhythms ventricular fibrillation and pulseless ventricular tachycardia are normally defibrillated. (There are also several heart rhythms that can be "defibrillated" when the patient is not in cardiac arrest, such as supraventricular tachycardia or ventricular tachycardia that produces a pulse, though the procedure is then known as cardioversion.) However, a 'flatline' may actually be a fibrillation that is too weak to be seen on the monitor (fine ventricular fibrillation), so a shock may be delivered, but it is not regarded as the treatment of choice, as the probability of a successful conversion is very small. According to the current guidelines, in this situation, continued CPR in order to improve the oxygenation of the heart for a few minutes is preferred before defibrillation is attempted. In medicine, asystole is a state of no cardiac electrical activity, hence no contractions of the myocardium and no cardiac output or blood flow. ... Ventricular fibrillation (V-fib or VF) is a cardiac condition which consists of a lack of coordination of the contraction of the muscle tissue of the large chambers of the heart that eventually leads to the heart stopping altogether. ... Ventricular tachycardia (V-tach or VT) is a fast rhythm that originates in one of the ventricles of the heart. ... A supraventricular tachycardia (SVT) is a rapid rhythm of the heart in which the origin of the electrical signal is either the atria or the AV node. ... For other uses, see Pulse (disambiguation). ... Through electricity or drug therapy, cardioversion converts heart arrhythmias to normal rhythms. ...

During the penultimate season of M*A*S*H, in the episode "Heroes", B. J. Hunnicutt saves a patient's life by using a hastily-assembled defibrillator after reading an article in a medical journal (contrary to history, Hawkeye Pierce suggests that the technique had previously only been tested on dogs). His colleague claims he's just invented a new way of saving lives. Season 10: 1981-1982 ... M*A*S*H is an American television series developed by Larry Gelbart, inspired by the 1968 novel M*A*S*H: A Novel About Three Army Doctors by Richard Hooker (penname for H. Richard Hornberger) and its sequels, but primarily by the 1970 film MASH, and influenced by the... Captain B.J. Hunnicutt (played by Mike Farrell) is a fictional character in the TV show M*A*S*H, which ran from 1972-1983 on CBS. Captain Hunnicutt resided in Mill Valley, California before he was recruited to join the US Army to fight in the War. ... Captain Benjamin Franklin Hawkeye Pierce is the lead fictional character in the M*A*S*H novels, film, and television series. ... Trinomial name Canis lupus familiaris The dog (Canis lupus familiaris) is a domestic subspecies of the wolf, a mammal of the Canidae family of the order Carnivora. ...

In the 1988 film Short Circuit 2, Benjamin used a defibrillator to provide the robot Johnny 5 with temporary power when its leaking battery ran out of power. It also played a chief role in a scene in the 1989 film The Abyss, when Lindsey Brigman allowed herself to be drowned in freezing water so she and her husband, Bud, could both make it back to the Deep Core underwater drilling station. // Michael Jacksons first film was Moonwalker Rain Man, starring Dustin Hoffman and Tom Cruise Who Framed Roger Rabbit, starring Bob Hoskins Coming to America, starring Eddie Murphy Big, starring Tom Hanks Twins, starring Arnold Schwarzenegger and Danny DeVito Crocodile Dundee II Die Hard, starring Bruce Willis The Naked Gun... Short Circuit 2 is a 1988 motion picture, sequel to Short Circuit directed by Kenneth Johnson. ... Johnny 5 explores the city. ... // Actress Kim Basinger and her brother Mick purchase Braselton, Georgia for $20 million. ... The Abyss is a 1989 science fiction film which was written and directed by James Cameron, starring Ed Harris, Mary Elizabeth Mastrantonio, and Michael Biehn. ...

In the computer games Battlefield 2 and Battlefield 2142, the defibrillator is a tool available for medics. Contrary to reality, they are surprisingly convenient and mobile tools that can quickly revive a fallen comrade, or kill an enemy soldier with a single jolt. Battlefield 2 (abbreviated to BF2) is a computer game in which players fight in a modern battlefield using modern weapon systems. ... Battlefield 2142 is a first-person shooter computer game designed by Digital Illusions CE and is the fourth game in the Battlefield series. ... A combat medic is a trained soldier who is responsible for providing first aid and frontline trauma care on the battlefield. ...

In the Wii Games Trauma Center: Second Opinion and Trauma Center: New Blood, Defibrilators are used once a patient goes into Cardiac Arrest. Gel is first applied (as in reality) and then the player must simultaneously hit a button at the right time on the Nunchuck Attatchment and Wii Remote, reviving the patient. The Wii (pronounced as the pronoun we, IPA: ) is the fifth home video game console released by Nintendo. ... The Wii Remote, sometimes nicknamed Wiimote, is the primary controller for Nintendos Wii console. ...

In the 1998 Bobby Farrelly and Peter Farrelly classic "There's Something about Mary" there is a use of a 'defibrillation' technique in a comedy setting. Matt Dillon's character, Pat Healey, has drugged a small dog in order to control its aggressiveness towards him. However he goes too far and the dog dies, and he has to go into quick action to save the dog. He performs a form of CPR, and then pulls electrical cord from a nearby lamp and "defibrillates" the dog with it. Bobby Farrelly is a screenwriter, producer and director from Cumberland, Rhode Island. ... Peter Farrelly is a screenwriter, producer, director and novelist from Cumberland, Rhode Island. ... Theres Something About Mary is an American film released in 1998 by 20th Century Fox, directed by Bobby Farrelly and Peter Farrelly (the Farrelly brothers). ... Matthew Raymond Matt Dillon (born February 18, 1964) is an Academy Award-nominated American actor. ... For other meanings of CPR, see CPR (disambiguation). ...

In Australia up until the 1990s, it was quite rare for an ambulance to carry a defibrillator. This changed in 1990 when Australian media mogul Kerry Packer had a heart attack and the ambulance that responded to the call did carry a defibrillator. After this, Kerry Packer donated a large sum to the Ambulance Service of New South Wales in order that all ambulances in New South Wales should be fitted with a personal defibrillator, leading to the Australian colloquial term for the device, Packer Whacker. For the band, see 1990s (band). ... A media proprietor is a person who controls, either through personal ownership or a dominant position in a public company, a significant part of the mass media. ... Kerry Francis Bullmore Packer AC (17 December 1937 – 26 December 2005) was an Australian publishing, media and gaming tycoon. ... Ambulance Service of NSW Logo NSW Ambulance uniform shoulder patch The Ambulance Service of New South Wales (ASNSW) is the main provider of pre-hospital emergency care and ambulance services in the state of New South Wales, Australia. ... NSW redirects here. ... A colloquialism is an informal expression, that is, an expression not used in formal speech or writing. ... It has been suggested that this article or section be merged into Defibrillator. ...

In the 2006 James Bond movie Casino Royale, Bond uses a defibrillator from his Aston Martin DBS, to revive himself after being poisoned with digitalis during his poker game. On returning to the table he remarks "Sorry; that last hand -- nearly killed me." 007 redirects here. ... Casino Royale (2006) is the 21st film in the James Bond series and the first to star Daniel Craig as MI6 agent James Bond. ... The Aston Martin DBS is a GT car produced by the British manufacturer Aston Martin Lagonda Ltd. ... Species About 20 species, including: Digitalis cariensis Digitalis ciliata Digitalis davisiana Digitalis dubia Digitalis ferruginea Digitalis grandiflora Digitalis laevigata Digitalis lanata Digitalis leucophaea Digitalis lutea Digitalis obscura Digitalis parviflora Digitalis purpurea Digitalis thapsi Digitalis trojana Digitalis viridiflora Digitalis is a genus of about 20 species of herbaceous perennials, shrubs, and... For the domestic fireplace tool, see fireplace poker. ...

See also

Electronics Portal

• Cardiopulmonary resuscitation (CPR)
• Advanced cardiac life support (ACLS)
• Cardioversion
• Implantable cardioverter-defibrillator
• Automated external defibrillator
• Heart Attack
• Ambulance

Image File history File links Nuvola_apps_ksim. ... CPR redirects here. ... Advanced cardiac life support or (ACLS) refers to a set of clinical interventions for the urgent treatment of cardiac arrest and other life threatening medical emergencies, as well as the knowledge and skills to deploy those interventions. ... Through electricity or drug therapy, cardioversion converts heart arrhythmias to normal rhythms. ... ICD An implantable cardioverter-defibrillator (ICD), also known as an automated implantable cardioverter-defibrillator (AICD), is a small battery powered electrical impulse generator which is implanted in patients who are at risk of sudden cardiac death due to ventricular fibrillation. ... An automated external defibrillator, open and ready for pads to be attached An Automated External Defibrillator or AED is a portable electronic device that automatically diagnoses the potentially life threatening cardiac arrhythmias of ventricular fibrillation and ventricular tachycardia in a patient,[1] and is able to treat them by application... A myocardial infarction occurs when an atherosclerotic plaque slowly builds up in the inner lining of a coronary artery and then suddenly ruptures, totally occluding the artery and preventing blood flow downstream. ... An ambulance in San Jose del Cabo, Mexico A Helicopter used as an Ambulance. ...

References

Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 166th day of the year (167th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 238th day of the year (239th in leap years) in the Gregorian calendar. ...

External links

Wikimedia Commons has media related to:

Defibrillator

• American Red Cross: Saving a Life is as Easy as A-E-D
• FDA Heart Health Online: Automated External Defibrillator (AED)
• Resuscitation Council (UK)
• History of defibrillation
• How an internal defibrillator is implanted from Children's Hospital Heart Center, Seattle.