Elena Gilbert is doing CPR on someone who’s having a heart attack. The cardiac monitor is on, doing that annoying ‘beeping per pulse’ thing rapidly — which doesn’t happen in a real hospital, by the way. The monitors do not beep per pulse. That would drive everyone up the wall and add unnecessary noise. It would beep as an alarm if the numbers were out of range of normal.
But the monitor is beeping in time with the patient’s pulse.
Patient has a pulse.
Elena Gilbert is doing CPR.
Wait, there’s more.
The doctor just elbowed Elena out of the way to listen to what happened. He interrupted the CPR. You do not interrupt CPR for anything except to call time of death.
He then rubbed the chest paddles together (what?!) and then slapped it on the patient’s chest and yelled “Clear!” without actually checking it’s clear.Why do doctors shout “Clear”? It’s to ensure nobody is touching the patient or the bed so they don’t get 360 Joules zapped into them and the oxygen supply doesn’t explode — the oxygen gets taken off the patient during the shocks.
Oh, look. Patient is in asystole. And they shock again. You do not shock in asystole (See ALS algorithm here).
After some very shoddy CPR, doctor called time of death. Throughout all this, he was the only medical person on the scene. During cardiac arrest, the arrest team arrives. More than one person. Usually at least one anaesthetist, one senior doctor, a few juniors, and the nurses who are on the ward, and a porter to deliver urgent bloods.
At the end of this sequence, patient is pronounced dead. Next of kin (daughter) runs in and is tearful. Patient recovers — fully. This is after Elena saying she had half an hour to an hour’s down time with shoddy, interrupted CPR, no airway protection, no blood tests done, no fluid resuscitation, after she had a heart attack bad enough to induce cardiac arrest.
CPR restarts the heart, but that is it. It doesn’t solve whatever caused the arrest in the first place — in the patient’s case, the artery is still clogged from the heart attack. But never mind, let’s keep her cognitively intact, alert, no damage, and not needing post-resuscitation care or ITU.
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