Medically Correct Writing

Resuscitation, Part 2: Jerking Bodies

The same story again: The patient's heart has stopped. Someone grabs a defibrillator. They shout "Clear!". The patient's body jerks off the table, and then he gasps as he is shocked back to life.

So, we've had flatlines in the last chapter. Now, can you spot the second mistake?

Part 2: Jerking Bodies

The patient's body jerks off the table... Well, it shouldn't, not that much at least.

Shocking, or defibrillation, doesn't involve complete body spasms. You get movement of the arms and legs, head too maybe, but the arching back is a fanciful invention.

The reason is the placement of the pads. Your electrical current goes from one pad to the other. One pad is placed under your right collarbone, and the other on the left side of your chest (for girls, about bra-height). The current mostly passes through the tissues in between these two points, so the majority of it doesn't reach the muscles of your back, neck, bottom, arms or legs.

During cardioversion (shocking a patient who isn't dying, not in an urgent setting, used to try and resolve certain irregular heart rhythms) a higher voltage is used, up to 100 Joules. I've seen one of those, and the patient's arms moved up towards his chest, his head flopped sideways, and his legs twitched a little. They weren't small movements, but definitely not the spasm-like jerking off the table you see in movies.

Sometimes, like on small children or babies, there might not be enough room on the chest, so you can put one pad on the back, and one on the front of the chest. I'm not sure if this will cause a spasm. I'm sure you'll be able to find a video if you ever need this in a story.

Also, if you can help it, try not to place the pad on a nipple. It might get slightly burned, and you can imagine that's not pleasant at all. Don't rub the pads together either. It might look cool, but it's unnecessary and it might damage the equipment. The only reason for rubbing them together is to spread gel on them evenly, but even that is not strictly necessary. Many modern pads don't use gel any more. Though if your characters are using old equipment, go ahead.

The idea of full body spasms probably comes from a psychiatric intervention called electro-convulsion therapy (used to be called electroshock). For this, they give an electrical shock through the brain, basically causing an epileptic attack. This activates brain cells, including the ones that control all of your muscles. Then, you get a spasm, all of your muscles contracting at the same time. That might seem like a cruel thing to do, but these days they give you plenty of sedatives and muscles relaxants so that you don't spasm at all. And, you're asleep.

It's used mostly for really bad depressions that can't be treated in any other way. And it works for some people, though it's a bit controversial.

So you see, if you only shock through the heart, the rest of your muscles are not affected that much. Full body spasms, like the ones you see on TV, you usually get those during an epileptic attack or ECT, when your brain cells are activated. (Of course, everyone is different, so some people might have stronger reactions than others)

And that was today's useful fact. Enjoy your week, and feel free to join in and leave some comments below. How accurate or inaccurate is your profession portrayed on TV?