Imagine that you are walking down the street or shopping at a supermarket and someone suddenly loses consciousness and falls to the ground. When you run over, you see that person is not breathing, and their chest is not beating. We have all seen this in movies, right? Then the doctors come and put a machine in their chest and give them a shock, and then they come back to life. That life-saving treatment that we are going to talk about today is defibrillation. This is not just a treatment, it can be the decisive difference between life and death.
What is defibrillation in simple terms?
Simply put, defibrillation is the delivery of a very controlled, precise electrical current to the heart. Now you might be thinking, " Wow , is this a shock?" Yes, it is. But this is not done to harm the heart, it is to save the heart.
Imagine your computer suddenly hangs and can't do anything. What do we do then? We restart it, right? That's how it is. When the heart suddenly becomes dysfunctional and cannot pump blood properly, this electrical shock is given to stop the dysfunctional heart for a second and then give it a chance to start working at its normal rhythm again. It's like "resetting" the heart.
This treatment is especially needed for two fatal heart rhythms involving the lower chambers of the heart, the ventricles.
1. Ventricular Tachycardia - Pulseless: This is when the lower chambers of the heart start beating too fast, more than 100 beats per minute. When the heart beats so fast, it doesn't have time to fill with blood properly or pump it to the body. After a while, the pulse becomes undetectable.
2. Ventricular Fibrillation: This is the main cause of Sudden Cardiac Arrest . What happens here is that instead of beating properly, the heart muscle starts to quiver uncontrollably. It quivers like jelly, and no blood is pumped. Since the brain and other organs do not receive blood, the person can die within a few minutes.
In a life-threatening situation like this, the best way to save a person's life is to administer defibrillation as quickly as possible. Every second counts.
Who needs this treatment?
This treatment is usually required for two categories of people. One is, as we mentioned earlier, someone who suddenly suffers a heart attack and is brought to the hospital, or someone who is dragged out in a public place.
The other group is those who are at high risk of developing this type of fatal heart rhythm. People who have had a previous heart attack, have weak heart function, or have a genetic heart condition may be at risk. For such people, there are personal defibrillators that they can keep nearby at all times.
| Device Type | How it works |
|---|---|
| Wearable Cardioverter Defibrillator | This is a device that you wear under your clothes, like a vest. The sensors on it touch your skin and constantly monitor your heart rhythm. If a dangerous rhythm occurs, it automatically detects it and delivers the necessary electric shock. |
| Implantable Cardioverter Defibrillator (ICD) | This is a small device that is implanted under the skin of the chest after a minor surgery. The wires from it are connected to the heart. It is like a pacemaker, but more advanced. It can control the heart rate if it slows down, and it can detect and deliver a life-saving electric shock if it develops a dangerously fast rhythm. |
The electric shock from an ICD can sometimes feel painless, and sometimes it can feel like a sharp pain, like someone kicking you in the chest. But at that moment, it can save your life.
What happens before and during defibrillation treatment?
Imagine someone is suddenly dragged and brought to the hospital's Emergency Treatment Unit (ETU). The doctors and nursing staff immediately jump into action.
Before treatment
Until the defibrillator is ready, the medical team continues to provide CPR (Cardiopulmonary Resuscitation) , which means trying to maintain some blood flow to the brain and other organs by compressing the chest and giving artificial respiration .
Once the machine is ready, before the electric shock is delivered, the person in charge shouts loudly, "Clear!" That means "Everyone clear!" At that moment, no one should touch the patient or the bed the patient is on. If they touch it, electricity can pass through that person's body, causing an accident.
During treatment
In a hospital, the doctor follows these steps.
| Step | Description |
|---|---|
| 1. Attaching Paddles or Pads | Two metal devices (paddles) or pads that can be attached like stickers to deliver electric shocks are placed on the patient's chest at two specific locations. One is placed below the right shoulder and the other below the left nipple. To prevent skin burns, an electrically conductive gel is applied to these. |
| 2. Delivering electric shock | The machine is charged to the required level of energy, and the doctor simultaneously presses the buttons on the two pedals. A button on the machine called a pad is pressed. At this point, an electric current passes through the chest and goes to the heart. |
| 3. Cardiac resuscitation | This electrical shock stops the heart's chaotic, quivering activity for a second. This then gives the heart's natural pacemaker a chance to take control again and start beating in a normal rhythm. |
AEDs in public places
You've probably seen an AED (Automated External Defibrillator) hanging on the wall in public places like airports, shopping malls, and stadiums. This is an automated defibrillator that anyone can use. If someone falls, all you have to do is grab this device and place the two pads on the patient's chest. The device then analyzes the heart rhythm and decides whether to give a shock. If necessary, it automatically charges and gives a voice prompt saying, "Press the button now." This can help save a life, even for someone without medical knowledge.
What happens after treatment?
After giving the electric shock, everything is not over. Next, the medical team immediately performs CPR again for two minutes . Then they check for a pulse and to see if the heart rhythm has returned to normal.
If the heart rhythm has not yet returned to normal, one or more shocks may be given, and medications such as adrenaline (epinephrine) or amiodarone may be given.
If the heart has started to beat but the patient is still unconscious, therapeutic hypothermia may be used to reduce brain damage. Once the patient is stable, tests such as cardiac catheterization may be performed to determine the cause of the condition.
How long does it take to heal?
Recovering from a sudden cardiac arrest and defibrillation treatment is a long journey that can take months, sometimes years. It is a great challenge, both physically and mentally.
- Physical discomfort: Many people feel fatigued. During CPR, the ribs in the chest can break, which can cause pain. Some people may also have difficulty walking or have seizures.
- Rehabilitation: It may be difficult to go to work or perform daily activities normally. Therefore, treatments such as occupational therapy, physical therapy, and speech therapy may be necessary.
Time and patience are very important for this journey. Family support is also essential.
When do you need to see the doctor?
If you see someone suddenly falling down somewhere, call 1990 immediately and call an ambulance. That's the most important thing you can do.
A person who has survived a heart attack is at a higher risk of having another heart attack. Therefore, the doctor will treat the underlying cause and often recommend implanting an ICD device for future protection.
If you have an ICD:
- Take the medications prescribed by the doctor as prescribed.
- Be sure to attend clinics to see if the ICD is working properly.
- The ICD battery usually needs to be replaced every 5-7 years. Your doctor will also inform you about this.
Although this is a long journey, with proper medical care and rehabilitation, you can return to normal life.
Take-Home Message
- Defibrillation is a life-saving electrical shock treatment that is given to restore normal rhythm to a dangerous heart rhythm.
- Time is of the essence in a cardiac arrest. Performing CPR until a defibrillator is available increases the chance of saving a life.
- AEDs in public places are designed to be used by anyone. Follow the instructions provided.
- A person who has survived a sudden cardiac arrest often has an ICD device implanted for future protection. This requires constant medical supervision.
- If someone collapses in front of you, call emergency medical services immediately. Your quick action could save someone's life.
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