The Truth About Defibrillators in Movies and TV

Many popular movies and TV shows portray defibrillators in a way that can be misleading and sometimes even dangerous. In reality, defibrillators are life-saving devices, but their use is more nuanced than the dramatised portrayals suggest. This article aims to debunk some of the common myths and misconceptions about defibrillators and bring you closer to the truth.

Myth 1: Defibrillators Can Restart a Total Flatline

One of the most widespread misconceptions about defibrillators is that they can revive someone with no electrical activity in their heart, commonly referred to as a 'flatline'. This is a critical misunderstanding, as defibrillators are specifically designed to treat a condition called Ventricular Fibrillation (VF), where the heart’s electrical activity becomes chaotic and fails to effectively pump blood.

The complete cessation of activity, or asystole, is indeed a situation that defibrillators cannot help with. Defibrillation requires the heart to be in a state of ventricular fibrillation, where it is still twitching randomly. In such cases, a defibrillator delivers a controlled electrical shock to restore normal sinus rhythm.

Reality Check: When someone is declared dead, it is typically marked by flatline on an ECG (electrocardiogram). At this point, defibrillation is ineffective. Only medical procedures such as resuscitation techniques, medications, and advanced life support can help.

Movie Hypocritiques: Clearing the Patient

Steps involving the clear of the patient before applying an AED are often depicted in movies, but these are crucial for safety and effectiveness. In reality, trained medical professionals prompt the crowd to stay back, a process that includes:

Verbal commands: "Does anyone have an AED? Clear the patient." Physical partitioning: Moving people away to ensure safety.

Failure to follow these steps can lead to electrical current diversion, which could be harmful to both the resuscitator and the patient. TV shows often skip these steps to make the action more dramatic, but they are essential for proper AED use.

Real-World Training for AED Use

First aid training emphasises that defibrillation is a critical step in resuscitation. However, it also stresses on the importance of CPR (Cardiopulmonary Resuscitation). An AED should be used in conjunction with CPR. In the cardiac arrest protocol, the current AA Trend (AED first, then CPR) is often recommended, though in real-world scenarios, the ABC Theory (Airway, Breathing, Circulation) is the standard approach.

Many TV episodes, like the one of Doc Martin, often depict a misstep where a person ignores the doctor’s direction to step back before using the AED. This is a realistic training point, as grounding accidents can occur if someone is too close to the patient during the defibrillation process.

Electrical Current and Safety

Another important point to consider is the electrical current and its effects on the human body. When someone is being defibrillated, there is a momentary electrical current that flows through the person's body. This current can cause a temporary loss of consciousness or other physical reactions. In movies, characters are often shown being briefly knocked out by this shock.

Reality Check: While the electrical current can have these effects, it is not the shock itself that revives the patient. It is the restoration of normal heart rhythm that potentially allows the patient to regain consciousness and breathing.

Conclusion: Ensuring Realistic and Safe Representations

While entertainment value is important in movies and TV, it is equally important to ensure that the portrayal of defibrillators and other medical procedures is realistic and safe. Misrepresentations like those seen in some shows can create dangerous misconceptions and mislead the public about the proper use of AEDs.

It is crucial for medical professionals, educators, and content creators to work together to ensure that the public is accurately informed about the capabilities and limitations of defibrillators. By doing so, we can save more lives and reduce the risks associated with cardiac arrest.