Polite Dissent

Blue Beetle #34 “Boundaries, Part Six: Monopoly”
Matthew Sturges, writer
Rafael Albuquerque, penciler

At the end of the previous issue, Dr. Polaris zaps Blue Beetle (Jaime Reyes) with a particular potent burst of magnetic energy, knocking him to the ground and — gasp! — killing him.

However, as is common in comic books, particularly among title characters, death is not always fatal.

When Dr. Polaris can find no heartbeat in the Beetle, he flies off. Since Polaris’s magnetic powers should be able to detect any cardiac electrical activity, it’s safe to say that Jaime’s heart is not functioning at all — in other words, he is in asystole (or flatline, if you prefer).

Time for Blue Beetle’s armor, the scarab, to work its mojo:

Epinephrine (otherwise known as adrenalin) is one of the recommended treatments for asystole. As shown, 1 milligram delivered intravenously is the standard dose in this setting. You’ll notice the author, correctly, did not have the scarab shock the flatline — which is a nice change.

The epinephrine works — it restarts the heart, but unfortunately it excites the heart too much and knocks Jaime into ventricular fibrillation, a potentially fatal heart rhythm.

The preferred treatment for ventricular fibrillation is to shock it (the machine is called a “defibrillator” for a reason — it is used to stop fibrillation). Quick treatment is key and the chance of successful resuscitation decreases by 5-10% for each minute defibrillation is delayed. With rapid defibrillation, the success rate of treating ventricular fibrillation nears 85%. The scarab follows through appropriately:

360 joules is the recommended setting for the treatment of ventricular fibrillation, at least when using a monophasic machine. Newer machines use biphasic defibrillation, which is felt to be superior (it has a higher success rate at any given energy level), but there is no recommended setting for these machines — it varies by manufacturer. Apparently for the scarab, it’s 360 Joules.

After 4 1/2 years of medically reviewing comic books, it’s nice to see one finally get the treatment of asystole correct.