The Top Ten Emergency / Medical Myths

I've decided to take a break from the mountains of safety materials and advice to do something a bit more entertaining, light-hearted, and every bit as informative as the other posts: I'm going to be pointing out and correcting the top ten most prevalent myths, misconceptions, and mistakes regarding Emergency Services and Emergency Medicine on the TV and silver screen.

1. Shocking Revelations: To me, this is the most glaring and particularly painful myth because it's the one that my favorite TV medical drama- House, M.D. -violates on an almost per-episode basis, thus, I put it first on the list. The myth is that you can shock asystole (layman's translation: flatline, or when the EKG just shows a solid, flat line with no heartbeat) and get a heartbeat back. If you get specific to House, then the myth becomes something like "You can replace CPR chest compressions with defibrillator shocks ad nauseum." This is massively incorrect on both parts. Asystole simply doesn't respond to a shock because the heart's already completely devoid of electrical signal. Sidestepping walls of text explaining the whole shebang, I'll sum it up by saying that it doesn't work because it's like trying to flatten out pizza dough that's already been made paper-thin. It's a genuine execrise in futility. Also, shocking someone repeatedly and in rapid sequence cannot replace CPR and will only result in the patient's man-nipples catching fire / chest hair becoming magnetized. What will bring a patient out of asystole is early detection of a problem, early CPR, and rapid implementing of Advanced Life Support treatments. For reference, a defibrillator is used to shock a patient out of two killer rythms known as 'Ventricular Fibrillation' and 'Ventricular Tachycardia' or V-Fib and V-Tac.
Here's what V-Tac looks like on an EKG, credit to medonline.com

And this is V-Fib on an EKG, credit to learnekgs.com




2. Oxygen is Flammable: No, it's not, else smokers would kill everything instead of just themselves. Our atmosphere, after all, is 21% O2 (That's the chemical way to express what we call Oxygen, which is really two oxygen atoms attached to each other). You see, Oxygen supports flame and combustion, but isn't, in itself, flammable. Now, as you can imagine, this can be cause for some serious problem if someone lights up around running medical oxygen supplies. A lit cigarette, when held under running Oxygen, will go from a slow smolder to a volatile flare that would make a match insecure. A struck match becomes a brilliant, short-lived fireball under similar conditions. A lighter may become a weapon of mass destruction, as well as a wonderful prank. Seriously, though, I've seen ambulances with their whole top half burned off because the fire got to the onboard oxygen tank.

3. Nitroglycerine patches will explode: Well, there's a bit of controversy about this one. Generally, they are very stable, and you can sit there and smack those patches with a hammer until your hand falls off and it won't do anything. Generally, heating them up will only result in an inactive, useless nitro patch (which is why they tell you, when they're prescibed, to store them out of regular heat and direct sunlight). Where this comes into issue is regarding defibrillation. While most people will tell you that they're stable and won't explode when zapped, we're still all trained to remove the patch before we shock. Even if it did explode, though, the amounts would be so miniscule that it'd do little more than flare up and maybe leave a bit of a burn on the skin.

4. Holding on to someone or standing in the same puddle as someone else when they're shocked will result in you getting tased, bro: This is one that some people may end up wrongly classifying as a myth, but this one's fact. Holding on to someone or sitting in the same puddle as them can and will result in you getting zapped right along with them, and it's famously unpleasent, albeit usually harmless. It's the reason that we say "Clear!" before the shock is administered (though in real life, there's a bit more looking around to make sure everyone's clear), and it's also the basis for the number one lie told by Paramedics- "I said 'clear'!"

5. 95% of cardiac arrests are easily brought back: Sadly, even with today's technology and medical science back us up, the statistic is much lower in reality- closer to 5% in some cases, though that's 5% higher than before we had these interventions. Still, if the movies are to be believed, what that low statistic tells us is that our medical professionals aren't believing hard enough, aren't yelling "C'MON!" enough times per minute, and are sorely lacking in the appropriate musical montages for success. (On a side note: CPR-of course, preformed appropriately- is at least twice as effective in domestic dogs compared to humans. Don't believe me? Ask your vet.)

6. You can cut a hole in someone's throat and keep them breathing through that if you must: You absolutely must not EVER under ANY circumstances attempt it unless you've recieved the appropriate training and are operating under the right medical direction, but this one is actually fact. You CAN cut a hole in someone's trachea, stick some straws (if that's all you've got, giving them a massive respiratory tract infection might be the most distant of your worries) or an Endotracheal tube in there and help them breathe through that. It's a procedure known as emergency open cricothyrotomy, though it's got a little brother that involves the use of a specific kit or a large IV needle to improvise an airway.

7. Firefighters rescue cats out of trees: The Atlanta Fire Department actually does have a protocol for it. That is all.

8. Police Arrest EVERYONE: This is outright false. Police officers are like anyone else, they'd rather just avoid the hassle if they can. If you're not doing anything illegal, you're not acting like a wound-up, dangerous person, and can keep yourself from outright harassing the officer for daring to waste your time to try and ensure the public's safety, you should be okay. If you watch COPS a lot, like I do, you might be tempted to think otherwise, but what a lot of people don't know is that it takes fox 30 straight days of riding along with those officers to make a single 30-minute episode, so you miss out on a lot of the regular stuff. Just whatever you do, DO NOT, UNDER ANY CIRCUMSTANCE EVER MENTION DONUTS. You see, people are sensitive to stereotypes, especially then they're true. (Hey, any Officers out there, I kid. I've got infinite respect for you guys and I've got a great friend working in law enforcement. That's how I know you guys really do like donu- Wait! Hey! Don't tase me, bro! Don't tase m-AAUUUUGGHGHGHGHGHG