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Effects on monitor rhythm when touching an asystolic victim


DwayneEMTP

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Hey all,

Hypothetical question...

Working a pt with a known down time of 30+ minutes prior to any intervention. Initial rhythm asystole. If you touched this person while the monitor was attached, could your electrical activity show some type of organized rhythm on the monitor attached to the pt? It seems like we've always been warned about this but I've never really given it much thought.

May seem like a silly question I guess, but it seems like it should. And if so, would where you were touching in relationship to the leads change what the rhythm would look like? Man, it seems like I should be able to reason this out, but trying makes my brain mushy....

Anyone have any actual information concerning this?

Thanks for any help you can provide...

Dwayne

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Hey all,

Hypothetical question...

Working a pt with a known down time of 30+ minutes prior to any intervention. Initial rhythm asystole. If you touched this person while the monitor was attached, could your electrical activity show some type of organized rhythm on the monitor attached to the pt? It seems like we've always been warned about this but I've never really given it much thought.

May seem like a silly question I guess, but it seems like it should. And if so, would where you were touching in relationship to the leads change what the rhythm would look like? Man, it seems like I should be able to reason this out, but trying makes my brain mushy....

Anyone have any actual information concerning this?

Thanks for any help you can provide...

Dwayne

Dwayne, I've noticed that when you are showing asystole on the monitor, you can get what appears like anything from an agonal to v-fib, depending on what is touching the pt. A simple touch can make an intresting spike and if you are next to a train track in a trailer, you could end up with a pattern...just be sure that nothing and nobody is touching the pt and you should be ok.

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You can generate "noise" or kinda v-fib looking stuff by touching and moving the patient, or a kinda VT looking rhythm if you tap the leads at a regular rate with your finger, but I've never really seen an organized rhythm show up over asystole from just passive contact with the patient.

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While at 30 minutes asystole untreated might make this problematic, any motion of the pad/paddle wires can generate artifact. They even used this as a plot device on EMT City's favorite show, "Trauma".

Everyone realizes I am being sarcastic about the show, but not the guy who was deliberately moving the wires ON the show?

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I would think that it depends on where you are touching the patient. If it's a 3 lead, then I doubt that touching the legs would make a difference. I would assume the closer you touch a person to where an electrode is, the larger the impact. I would also suggest that it also depends on the size of the patient- a 90lb nursing home patient vs a 350 pound CHF'er. Next time I have an arrest, I'll need to discreetly check this out.

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