Medically Correct Writing

Resuscitation, Part 4: Miraculous Revival

Remember that scene from our first three parts, the one we've been discussing over and over again? We'll do it one more time.

Part 4: Miraculous Revival

The patient gasps as he is shocked back to life... Well, not really. Or at least, not usually.

First, after a shock, it might take a few seconds for the heart rhythm to normalise. Many times, you might not even notice it is back to normal until the next shock cycle. That means you've been doing CPR for a full two minutes, while the heart rhythm was already stabilised. That's normal.

You won't stop CPR immediately after shocking, because you don't know yet whether it worked. And can't waste a whole minute waiting around, watching the heart monitor. Every instant you're not shocking a patient, you should be doing CPR. You'll only stop to look at the heart rhythm the next time you stop to shock. Then, you might realise it's not necessary any more, meaning your previous shock worked. Deep sigh, everyone relieved. Patient lives.

Second, no gasping. Sorry, but it just isn't that spectacular. People don't just open their eyes, take a deep breath and are fine again. Most people who need resuscitation are severely ill, and breaking a few ribs during chest chest compression doesn't really help. The best you might expect is a bit of moaning. Moaning is good. It means your patient is breathing again, and you can stabilise them, put them in a safe position, and wait for help.

Third, the sad truth is that very few patients survive a true cardiac arrest, even with resuscitation. Even with a well-trained team and the best equipment, the percentage of survival is low. A quick internet search gives me around 10-20%. On the small screen, the survival rate is around 75%. 

Even so, if you don't do anything, the percentage of survival is zero.

Quick real life tip: My teachers always told me that it's better to do something than to do nothing at all. If you're one of the only ones around, and there's no one who had training, then even what little you can do is better than nothing. Always look for an AED, or send someone to look for it. Its symbol is a heart with lightning through it.

Fourth, people who go into (shockable) cardiac arrest usually aren't young healthy people. If your characters, who are likely to be young and healthy, get some sort of trauma (physical, not mental), you might consider a cardiac arrest for dramatic purposes. It just isn't very likely without any preexisting conditions. There's plenty of other ways to express trauma!

I understand resuscitation can be nice for plot points, but perhaps try something other than cardiac arrest? It's a really serious condition, and even those who survive don't always emerge undamaged. Several minutes without blood supply to the brain is not good at all. Even if resuscitation works, you don't just get up and walk away after that (remember those broken ribs, and brain damage?). And don't forget about the cause. It's usually quite significant, if it can cause your heart to stop beating.

So, conclusion: low chances of survival, possible brain damage and broken ribs afterwards, severely ill patient. Not quite like in the movies, where they somehow manage to fight off an army after being resuscitated.

I hope you enjoyed today's info-dump. If you have questions, please ask. I know I can get a bit chaotic during explanations. And always remember to do your own research, or maybe ask doctors you know what they think. Things might be done differently where you're from.