Shock To The Heart

Ever seen someone get shocked while still conscious? Neither had I.

I recently ran a call on a 30-year-old woman who was having chest pain. She was Indian and there was a language barrier. We tried getting the story from the husband, but he was little help. Her vitals were good and we couldn’t figure out why she was in such distress. Her clinic “doctor” had diagnosed her with anxiety the night before, so perhaps this was emotional.

We got her into the ambulance and put her on an EKG heart monitor, at which point we realized she had an outrageously high pulse rate of 200 beats per minute. The firefighter on scene had taken a horribly inaccurate pulse. This was the highest pulse rate I’ve ever seen on a patient. Her heart was beating out of her chest and the monitor just showed scribbled lines. We all kicked into high gear.

On this day I was driving the rig and the medic in the back was unable to get an IV line on her to give her drugs to slow her dangerously high heart rate down. It was at this point that I heard him say,

“I can’t get a line, so… really push it”.

It my entire time as an EMT, I have NEVER had a medic tell me to drive faster. But the reality was, we couldn’t slow her heart in the field and any minute her heart could give up and stop.

If you think you’ve got road rage, try driving an ambulance during rush hour. Every lane is blocked; people are idiots on the road and get in your way. I hauled with screaming sirens, opposing traffic and swerving around cars. I kept hearing “we’re almost at the hospital. Just hang on”. This poor woman was about to go into cardiac arrest.

For some reason, this was more nerve-racking than someone who is already in full arrest. A full arrest patient is already technically dead, and you’re trying to bring them back, but when someone is on the verge, or circling the drain, it’s all on you. It takes a lot to get my adrenaline going these days, but this certainly did it.

Once we got her to the hospital, the doctors immediately tried giving her drugs, but they didn’t slow her heart. They only had one last resort left. They had to shock her heart to restart it. The trouble was, she was still conscious. I’ve only seen this done on people who are unconscious.

Everyone stood back and the doctor told her, “Ma’am, you’re going to feel a shock.” 

Yeah,.. I’ll say. As the charging sound rang, I didn’t know what kind of reaction to expect. What followed almost made me burst out laughing in the room. I know, terrible, right? The woman reacted like a confused drunk who has a huge hiccup. Her upper body jumped, and she wearily faded back with a priceless look of confusion on her face. And boom, her heart restarted itself back to a healthy rate of 104 bpm.

Turns out the woman was having a heart attack, and shocking her saved her life. Still, I’d never want to be awake for that.