How Not to Defibrillate (aka “Medical Review of The New Avengers #58, part 1″)

November 3rd, 2009

Filed under: Comics, Medicine


scene from New Avengers #58
scene from New Avengers #58

The basic concept of defibrillation is to provide enough current to knock the heart back into a normal rhythm, but not enough to do any damage.

I think Norman Osborn missed that memo.

This may or may not be “shocking a flatline.” All we know is that the doctors can’t find a pulse; we don’t know anything about the electrical activity within the heart.

So it could be a flatline (asystole), PEA (pulseless electrical activity), or a ventricular tachycardia/fibrillation where the heart’s beating so fast, it’s unable to produce a pulse.

Defibrillation is the right choice in the last situation, but wrong in the first two. This is why electrical monitoring is important. In any case, CPR would be appropriate.

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9 Responses to “ How Not to Defibrillate (aka “Medical Review of The New Avengers #58, part 1″) ”

  1. Bytowner
    November 4th, 2009 at 7:58 am

    Fairly certain that Mr. Osborn chose to ignore the memo’s contents in this instance…

  2. Anonymous
    November 4th, 2009 at 11:19 am

    Scott, what you wrote about ventricular tachycardia / fibrillation reminded me of an episode of the Justice League where Flash – contained by the Justice Lords Batman – sped up his heartbeat so much that his pulse rate monitor flatlined. Was that awesome, stupid, or somewhere in between?

  3. Seangreyson
    November 4th, 2009 at 1:13 pm

    To be fair, one of the other reasons the medical staff can’t find a pulse may be due to the unbreakable skin problem again. I would imagine the very slight vibrations from a pulse would probably be harder to feel through skin which bullets bounce off of.

    Which would make Osborn’s actions even less significant.

  4. Chris
    November 4th, 2009 at 5:53 pm

    Isn’t the purpose of supplying a large electrical charge to the heart to sort of override the existing electrical signals and cause the heart to contract, and then once the charge has dissapated, the normal signalling from the brain takes over. That’s why it’s worthless to shock a flatline, because a flatline means that the signal from the brain is not reaching the heart.

  5. Alberto
    November 4th, 2009 at 6:12 pm

    >>From the scene depicted above, it is unfair to criticize Norman Osborne.

    The doctor clearly (as I can infer from Doc Scott’s explanation) made a mistake by stating he needed paddles. So it doesn’t matter if N.O. defibrillated in the wrong way: the “right way” defibrillation would make no difference, right?

  6. Alberto
    November 4th, 2009 at 7:31 pm

    Oh, and as a electrical engineer, I am more than tired of these scenes where the effects of huge electric discharges need to be shown graphically as huge bolts.

    Electric current is not light and it’s not heat: it is just electrons in motion. Whomever took a shock from a power outlet knows that even when there is no spark, it hurts a lot.

    The voltaic arch only means that a lot of energy was wasted breaking the dielectric (air in the case) and the loss was heat and light. If N.O. was touching the patient’s chest, no spark would be seen: the dramatic kickback of the patient’s body would happen way before there was any spark.

  7. Kat
    November 4th, 2009 at 10:27 pm

    @Alberto Rule of cool, my good gentleman.

  8. animus
    November 5th, 2009 at 4:21 am

    Isn’t the purpose of supplying a large electrical charge to the heart to sort of override the existing electrical signals and cause the heart to contract, and then once the charge has dissapated, the normal signalling from the brain takes over.

    More or less, except the signal doesn’t come from the brain. It’s generated in the heart itself, by a series of regions collectively referred to as the pacemaker.

  9. Chris
    November 5th, 2009 at 12:48 pm

    And I learn something new. Thanks animus.

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