You've probably seen it on TV or in a movie, when someone suddenly loses consciousness and falls to the ground, doctors or nurses run over and put two iron-like devices on their chest, shout "Clear!" and give them an electric shock. That's what we call a defibrillator. But it's not just a machine that gives a shock. It's meant to save the life of someone who is close to death. So, today we'll talk about this very important device in a simple way that you can understand.
Simply put, what is a defibrillator?
Think of our heart as a small motor that works in a certain rhythm. It has an electrical signal system for its functioning. Sometimes, due to a defect in this electrical signal system, the heart stops beating in the right rhythm and starts to flutter. We call this an abnormal heart rhythm, or arrhythmia .
Of these arrhythmias, there are two that are the most dangerous and immediately life-threatening. They are Ventricular Tachycardia (when the heart does not beat) and Ventricular Fibrillation . Simply put, in both cases, the lower chambers of the heart (ventricles) do not pump properly, but simply quiver. This can completely stop the pumping of blood to the body, especially the brain, and death can occur within minutes.
That's when a defibrillator comes to our rescue. What this device does is deliver a controlled, powerful electrical shock to the heart, instantly stopping the erratic electrical activity and giving the heart a chance to return to its natural rhythm. To be precise, a defibrillator 'restarts' the heart.
Who needs a defibrillator? What are the types of defibrillators?
Normally, if an emergency like this occurs in a hospital, doctors would immediately use a defibrillator. Also, now in many public places, such as airports and large shopping malls, there is a type of defibrillator that anyone can use. It is called an Automated External Defibrillator (AED) .
However, some people are at a much higher risk of developing this dangerous arrhythmia. For example, someone who has had a previous heart attack or has a weak heart. For such people, there are personal defibrillators that they can carry with them at all times.
Let's take a clear look at these types.
| Defibrillator type | Description and functionality |
|---|---|
| Automated External Defibrillator (AED) | These are the ones found in public places like airports, stadiums, and shopping malls. The device is designed to be used by anyone without medical training. Once the two stickers are placed on the patient's chest, the machine analyzes the heart rhythm and decides whether to deliver a shock. If a shock is needed, it gives voice instructions on how to do it. |
| Wearable Cardioverter Defibrillator (WCD) | This is a device that is worn under clothing, like a vest. Sensors that touch the skin constantly monitor the heart's rhythm. If a dangerous arrhythmia is detected, the device automatically delivers a shock. Your doctor may recommend this as a temporary device for people who are at risk of heart disease but are waiting for a permanent device to be implanted. |
| Implantable Cardioverter Defibrillator (ICD) | This is the most commonly used type of personal defibrillator. This small device is implanted under the skin of the chest during a minor surgery. A wire from it is connected to the heart. Like a sentinel placed in the heart, this ICD monitors the heart's rhythm 24/7. When a dangerous rhythm occurs, it delivers the necessary electrical shock to restore the heart to normal. Although it is similar to a pacemaker, the special ability of an ICD is that it can deliver this life-saving shock. |
What does a defibrillator shock feel like?
A shock from a personal defibrillator, such as an ICD, can sometimes be painless . But in other cases, it can feel like someone has kicked you in the chest . However, at that moment, saving a life is the most important thing.
What are the steps to using a defibrillator?
Imagine that someone suddenly falls unconscious in your area. The first thing you should do is call the 1990 Suwaseriya Ambulance Service . Then, if you are trained, you should start CPR (Cardiopulmonary Resuscitation) . In the meantime, if there is an AED nearby, you should bring it.
Here's how to use a defibrillator (specifically an AED):
1. Continue CPR: If possible, continue CPR until the defibrillator is ready. CPR aims to maintain some level of oxygenated blood flow to the brain and other organs.
2. Create space around the patient: When administering the shock, make sure that no one is touching the patient or the bed the patient is on . Otherwise, they could also be electrocuted.
3. Place Pads or Paddles on the Chest: There are two sticker-like pads or metal paddles attached to the defibrillator. These need to be placed in two specific locations on the patient's chest.
- One: below the right shoulder.
- The other: below the left nipple, obliquely.
- The stickers that come with AEDs have pictures showing where to stick the pads. The pads used in hospitals are placed on the chest with a special gel applied to stop the skin from burning.
4. Deliver the shock:
- If it's an AED, it automatically analyzes the heart rhythm and says "Shock advised." Then, it instructs you to press the button on it.
- In a hospital, the doctor checks the rhythm on the monitor, decides to give a shock, and presses the buttons on both paddles at the same time.
After the shock is given, the doctor or first aider will perform CPR again for about two minutes . Then they will check to see if the pulse is dropping and the heart rhythm is returning to normal. If necessary, another shock and CPR will be given. Sometimes, medications such as epinephrine or amiodarone are also given to help regulate the heart rhythm.
What are the benefits and risks?
The biggest and only advantage of a defibrillator is that it can save a life . If a shock can be delivered with a defibrillator within the first 10 minutes of the onset of the two dangerous arrhythmias I mentioned earlier (VT and VF), the chances of saving a life are very high.
There are also risks. The biggest risk is using a defibrillator for an abnormal heart rhythm . A defibrillator should only be used for Ventricular Tachycardia (no pulse) or Ventricular Fibrillation. If a shock is given to someone with a different heart rhythm, it can cause that person to go into Ventricular Fibrillation, which can cause the heart to stop.
This is why AED devices automatically analyze the heart rhythm before delivering a shock. And in hospitals, only a trained doctor makes this decision.
Recovery and life ahead
Recovery from sudden cardiac arrest and defibrillation is a long journey that can take months, even years . It's not something that gets better in a day or two.
- Physical discomfort: During CPR, the chest bones (ribs) can break. The pain takes time to heal. There may be extreme fatigue, difficulty walking, and possibly seizures.
- Occupational and physical therapy: Many people may find it difficult to return to work and perform daily tasks. Therefore, treatments such as occupational therapy and physical therapy are needed.
- Psychological impact: It takes time to recover mentally after facing such an experience.
If you have an ICD, it is important to see your doctor regularly to make sure it is working properly. The battery in your ICD usually needs to be replaced about every five years. It is also important to take the medications your doctor prescribes exactly and on time.
Take-Home Message
- A defibrillator is a valuable device that can save lives by correcting certain life-threatening abnormal heart rhythms (arrhythmias).
- What it does is deliver an electrical shock to the heart, "restarting" the disrupted electrical process and giving the heart a chance to return to its natural rhythm.
- AED devices available in public places can be used by anyone without medical training by following the voice instructions.
- If you are at high risk due to a heart condition, your doctor may recommend a wearable (WCD) or implantable cardioverter defibrillator (ICD).
- If someone falls unconscious in front of you, the first thing to do is to call the 1990 ambulance service immediately.
- Recovery from a sudden cardiac arrest and defibrillation treatment is a long journey. Patience, following medical advice, and family support are essential.
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