True Stories of the ER 2: Cardioversion

A few nights ago, I was again privy to a procedure that is one of the highlights of being an ER nurse. It is the kind of thing that makes all the bandaging open, infected sores, and people flipping you off when they don't get their pain meds worth it. Extremely fast heart rates are usually due to atrial fibrillation (where the electrical node and muscles in the atrium of the heart kind of quiver like Santa's jelly belly) but also can be caused by other ectopy- or runaway beats (ie: supraventricular tachycardia). When a patient comes in with one of these conditions we (obviously) have to do something to bring their heart rate down (heart failure, heart attack, embolism blah blah blah). Usually the cure consists of giving patients some medication to kind of stop and restart, or slow the heart rate. Some people's hearts are resistant to these medicines, so we have to 'manually' stop and restart the heart with electrical currents. Sounds barbaric, huh? You should see it. You attatch a couple of pad doohickies (that's technical!) to the patient's chest- select a low voltage (usually 50 jules) on the shockin' machine (I think that's it's real name...:), give some sedating medicine, and call out, "I'M CLEAR, YOU'RE CLEAR, EVERYBODY CLEAR!" (just like the show!- K-not really). The patient then receives the shock of their lives. Lit'rally. Their limbs fly above their head and their body bounces like silly putty on the crappy foam ER stretcher. The heart monitor stops and restarts, and then (every time I've seen it) the person's heart rate is normal again. The weird part is, a few minutes later the person wakes up and starts speaking (usually talking about how they have a raging headache). Who discovered that you could just zap someone's heart to make it better? Hmmm... don't think I'd wanna be in on that research study. Then again- I would go to watch... Amazing.