You must have seen it on TV, when someone suddenly loses consciousness and falls down, the doctors rush in, put a machine on the chest and say 'Clear!' and give an electric shock. But sometimes all you see on the monitor is a long straight line. That's what we call a 'flat-line' or asystole. This is a very serious, life-threatening medical emergency. So, it's very important for all of us to be fully aware of this.
What exactly is asystole?
Simply put, asystole is when your heart's electrical system completely shuts down and your heart stops beating. This is a type of cardiac arrest. At this point, the heart stops pumping blood to the body completely. This can cause sudden loss of consciousness, breathing stops, or suffocation. Without immediate medical treatment, such as CPR, death can occur within minutes.
Why is this called a 'flat-line'?
We cannot tell this condition from the outside. It can only be accurately determined with an ECG (Electrocardiogram) test. You may have seen that in hospitals, several sensors are attached to the chest to monitor the functioning of the heart. These sensors detect the subtle electrical activity of the heart and display it as a wavy pattern on a screen.
This wave pattern is formed when there is an electrical activity in the heart. In asystole, there is no electrical activity in the heart, so instead of the wave, only a straight, flat line appears on the screen. That's why it's called a 'flat line'.
How does our heart work? What happens during asystole?
Every time our heart beats, it happens in two main steps.
1. Systole: A small electrical impulse that occurs inside the heart causes the heart muscle to contract strongly. This contraction is what pumps blood from the heart throughout the body.
2. Diastole: After one beat, the heart muscle relaxes. This is when the heart chambers fill with blood again, ready for the next pump.
In asystole, the electrical current that causes systole is completely lost. Just as a water motor stops working when the current is lost, when the electrical process is lost, the heart stops pumping completely. This is what we call 'clinical death'.
Brain cells can only survive for a very short time, about five minutes, without oxygen and blood supply. If the heart can be restarted within this time, there is a small chance of saving the life. That is why every second is so precious here.
What are the causes of asystole?
There are a number of reasons why the heart can suddenly stop working. Some of the main reasons are:
- Excessive bleeding from the body.
- Dangerously low oxygen levels in the body (Hypoxia).
- Salt and electrolyte imbalances in the body.
- A severe heart attack.
- Pulmonary embolism.
- Abnormal heart rhythms (Arrhythmias), especially conditions such as Ventricular Fibrillation (VF) and Ventricular Tachycardia (VT).
- A serious accident to the chest or heart.
- Electric shock.
- Ingestion of certain medications, toxins, or drugs such as cocaine.
How can this be treated? Can it save a life?
Asystole is a medical emergency where every second counts. If this happens to someone outside of a hospital, the most important and only thing you can do is start CPR (Cardiopulmonary Resuscitation) immediately and continue it until medical help arrives. Proper, continuous CPR has the best chance of saving a life.
If inside a hospital, medical teams provide the following treatments.
| Treatment method | Description |
|---|---|
| CPR (chest compressions and artificial respiration) | This is essential to pump blood to the brain and other organs, replacing the heart that has stopped beating. |
| Epinephrine (Adrenaline) | A drug that can help restart a stopped heart. It is given through a vein. |
| Treating the underlying cause | The heart can be restored to normal by finding and treating the underlying cause of cardiac arrest (e.g., salt deficiency, poisoning). |
Can't a shock (defibrillation) revive a heart?
This is something that many people mistakenly assume after watching movies. Asystole is not a 'shockable' rhythm. That is, giving someone with a flat line an electric shock (defibrillation) will have no effect. In fact, doing so can make it more difficult to resuscitate the heart.
Shocks are only given for abnormal rhythms, such as Ventricular Fibrillation (VF), where the heart's electrical activity is disrupted and the heart is just quivering. However, with good CPR, sometimes a heart in asystole state can be converted to a shockable rhythm. That's why CPR is the number one treatment here.
When should you seek immediate help?
If someone near you suddenly experiences the following symptoms, it could be a cardiac arrest.
- Suddenly losing consciousness and falling.
- Not breathing or gasping for breath.
- Loss of pulse in the neck or wrist.
In such a situation, immediately call an emergency ambulance service (for example, 1919). Then, start CPR as soon as possible. Even if you do not know how to do CPR, do not panic. The ambulance service officer can teach you how to do CPR over the phone. Your efforts have a high chance of saving a life. The patient should be taken to a hospital's Emergency Treatment Unit (ETU) immediately.
If you suspect that this has happened due to a toxic substance, you can immediately call the National Poison Information Center at the Colombo National Hospital and seek advice.
Take-Home Message
- Asystole, or 'flat line', is the complete cessation of the heart's electrical activity. This is a very dangerous medical emergency.
- This is not a condition that can be cured by giving an electric shock, as shown in the movies.
- If someone suddenly loses consciousness and collapses, the most important thing to do is to start CPR immediately and continue until medical help arrives.
- If you see such a situation, don't panic, call an emergency ambulance immediately and start CPR. Those who don't know how to do CPR can get instructions over the phone.
- Learning how to perform CPR could help you save the life of a loved one someday.
💬 අදහස් (0)
තවමත් කිසිදු අදහසක් පළ කර නොමැත. ඔබේ අදහස පළමු වරට මෙහි එක් කරන්න.
ඔබේ අදහස එක් කරන්න