I got zapped

MagicTyler

MagicTyler

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I was working a code today and the pt had an internal defibrillator. Its 3 hours post code and my arms are still tingling. I was zapped about 4 or 5 times. At first we thought someone accidently did it with the lifepack, but after the second shock we figured it out. Then we couldn't locate a magnet to disable it. So we worked the code with him zapping us ever few minutes. I can really feel for anyone who's defibrillator malfunctions, that is quite a painful experience. Another weird deal with this code was he had spontaneous respirations even after 30 minutes down time with no cardiac activity verified by ultrasound. It was very eirre, even the doc was concerned. We ended up restarting the code after the doc called it. End the end code didn't work out, but we did try the hardest we possibly could.
 
That's when you look for something non-conductive to do compressions with. leather work gloves, breakup a cardboard splint, anything nonconductive to isolate yourself from your patient.

note: As with many things, solutions are much easier thought of after the fact than in the heat of the action.
 
This is interesting my class never mentioned that happening.

What do you mean magnet?

Is that how you turn off an implanted defibrillator?
 
emtseeking,
You can place a high powered magnet over an implanted defib. to turn it off/reset it.
 
is there any chance that these contact shocks could compromise your safety somehow?
 
Wow that's crazy lol...are the spontaneous respirations after the heart stoping called Agonal resp?or was it something different...and I worked my very first code tonight
 
Thats not common at all. Dealt with several folks being internally defibbed, even while starting an IV, never felt anything. Wildness.... got me curoius now.... I think I will take a trip to our implant department and ask around.

I know we carry 'doughnuts', which are round magnets used for that pupose, many internal pacemaker/defib will let off an audible tone when they are temporarily off.

I hope you filled out an workplace injury report form and got that stuff rolling in case you have long term effects from it.
 
Weird. When we discussed this in class the instructor said it'd feel like a tingle when it went off but nowhere close to the pain you're talking about.
 
Once you figured out it was the internal defibrillator, it would have been a good idea to at least double glove. That will give you some protection, possibly enough to prevent the shocks altogether. Also, remember good CPR means that spontaneous respiration is possible on codes.
 
The shocks were exactly like when we shock with an external defib. He convulsed and it sounded the same. I had no idea an internal defib was able to shock like that.
 
I had this happen to me as well once except the lady was conscious and alert. She grabbed on to my arm and wouldn't let go till she coded. Id say I got it at least 10 times. My arm did feel odd for quite a while.
 
I thought those internal defibrillators only shocked at like 5 joules or something ridiculously small like that. I think the question you need to be asking is who was operating the monitor? and does that person not like you ^_^

"I'm clear, you're clear, every..." *BZZZT!*...... nope Mikey wasn't clear.
 
I recall a study that showed the current leakage from EXTERNAL pads to a rescuer performing chest compressions was very low and shouldn't pose a health risk to the rescuer.

http://circ.ahajournals.org/cgi/content/short/CIRCULATIONAHA.107.763011v1

I would be surprised if, with the new focus on continued compressions, we weren't instructed to defibrillate during compressions with no pause at all. Of course, there will be more research and some company will make a million dollars selling special "insulated CPR gloves". ^_^

As an aside, I've done CPR on a pt with an ICD and while I felt the pt contract at the time of shock, I didn't feel a tingle. However, my experience should be considered nothing but anecdotal, and YMMV.
 
You have to stop CPR in order for the AED to determine whether or not the pt has a shockable rhythm. I believe this is the main reason they have you clear before the AED analyzes; in order to avoid the machine picking up any rhythm from another person.
 
ngbacon said:
You have to stop CPR in order for the AED to determine whether or not the pt has a shockable rhythm. I believe this is the main reason they have you clear before the AED analyzes; in order to avoid the machine picking up any rhythm from another person.
Click to expand...
A lot of the newer monitors you can see the rhythm through the CPR, not sure if newer AED's are that good. But like someone else said I have also heard that touching a pt while using a biphasic monitor is actually safe. I heard it was the old school monophasic paddles that were dangerous.
 
The ICD's normally shock between 13-18j. They have a max of 50j.

The research done shows minimal chance of ever feeling the energy from one, especially through the skin. One study found that partners could not even feel it during sexual intercourse.

I have dealt with the first generation ICD's that shocked at much higher outputs and the only time it was ever even noticed, was during IV cannulation.

Since the old styles have been gone for at least 5 years, I doubt many have come across them.
 
reaper said:
The research done shows minimal chance of ever feeling the energy from one, especially through the skin. One study found that partners could not even feel it during sexual intercourse.
Click to expand...

"So, you have a heart that goes out of rhythm during heavy exertion? Well then, here's an internal defibrillator, why don't you and your wife head next door to get it on so we can see what happens."
 
jjesusfreak01 said:
"So, you have a heart that goes out of rhythm during heavy exertion? Well then, here's an internal defibrillator, why don't you and your wife head next door to get it on so we can see what happens."
Click to expand...

I was just sitting here wondering how they performed that study. Then again, I remember the studies where individuals would have sex in a modified MRI and under fMRI. Also, ICD's and MRI scanners would be an open market for a fetish website, I could be rich one day.... just sayin.

The study:
http://www.bmj.com/cgi/content/full/319/7225/1596
 
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