Wattpad Block Party - Summer Edition IV

KatrinHollister Presents: Top 5 Medical Bullsh❤t on TV

My name is Katrin Hollister and welcome to my second WATTPAD BLOCK PARTY post! I mainly write fantasy with copious amounts of backstabbing, political conflict, manipulation, and death, and with little or no romance. By day, I am also a paediatrics doctor. I graduated with an MBChB degree from the UK in 2015 and have been working in a variety of specialties, including general surgery, gastroenterology, palliative care, orthopaedics, respiratory medicine, and acute medicine since.

You know what really gets a medical professional (e.g. paramedics, nurses, doctors etc.) riled up when watching TV drama? Medical bullsh*t. There's nothing wrong with dramatising or adding a dash of fiction to your medical setting. Heck, nobody watches medical drama to learn about medicine and if you're a writer worth your salt, you wouldn't do research on writing hospital scenes from watching Grey's Anatomy either. But the issue is when TV gets things so wrong, so often that it gets ingrained into the regular Joe's mind that it's actually how medicine works. And that's when things get dangerous -- because they think they can implement it in real life or have unrealistic expectations of medicine because "that's not what it's like on TV".

So, today, join me for my Top 5 things fiction often gets wrong in medicine. It'll be a useful read if you want to include hospital or medical scenes in your writing. Please note there may be regional variances in terms of hospital policies, legalities, and protocols.

1) "OMG HE'S FLATLINING!!"

The most common occurrence in fiction and literally the thing that grinds a medical professional's gears. Because you wanna know why?

You don't shock asystole.

See the second one up from the bottom? That is asystole, AKA 'flatline'. It means there is no electrical activity in the heart. Shocking it will not work. Compare it with attempting to restart a computer when the socket isn't plugged in. It won't work. You do CPR. You give IV adrenaline. You do more CPR until the rhythm changes or you announce time of death. Same for PEA (bottom pattern). For further details on how cardiac arrests are managed, see the ACLS algorithm.

(Yeah, 'Flatliners' the film, you can shut up.)

There are only two shockable patterns: ventricular fibrillation (VF; the diagram above splits it into 'fine' and 'coarse' but it's the same management. This is when the heart is beating but it's super uncoordinated and quivering like mad, i.e. 'fibrillating', and not pumping out any blood effectively as a result) and ventricular tachycardia (VT. This is where the main pumps, the ventricles, of the heart is pumping rapidly, regularly, but disregarding whether it's actually filling with blood or not, so you still don't have any effective blood pumped out).

Every single medical scenario ever that delivers a shock (defibrillation) to asystole is wrong, wrong, wrong.

Side point: when someone yells 'Clear!' prior to delivering a shock, please have your character actually looking and checking the area is clear, i.e. nobody is in physical contact with the patient, otherwise, you will actually electrocute them.