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little_aIconFlatline04-08-2015 @ 14:47 
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Just came up in conversation... if someone is having heart surgery and needs to be put on bypass for the duration does that person actually flatline as there is no actual heartbeat, or is the mechanical action of the bypass the temporary heartbeat? Also, do bypass machines function on a steady state action or are they set up to actually simulate a rhythmic pumping of what your heart rate and pressure would be considered to be?

I know someone know's this stuff.
Funky_monkeyIcon...04-08-2015 @ 15:05 
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little_a said:Just came up in conversation... if someone is having heart surgery and needs to be put on bypass for the duration does that person actually flatline as there is no actual heartbeat, or is the mechanical action of the bypass the temporary heartbeat? Also, do bypass machines function on a steady state action or are they set up to actually simulate a rhythmic pumping of what your heart rate and pressure would be considered to be?

I know someone know's this stuff.


There still needs to be a steady PQRST wave, which is what the ECG monitors during a bypass. The valves still need to open and close at the right time, it's just that some of it is bypassed whilst the heart is still beating. There shouldn't be a flatline, or there's no blood being pumped around and the guy is dead!

I think that's the case, anyway.

I'm by no means a medical expert, and would be interested in finding out a proper answer from somebody more qualified (or just plain old qualified, which I'm not!)
little_aIcon...04-08-2015 @ 18:36 
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Sorry, should have added, the conversation moved on to heart transplants and such where by there is no heart for a time, and hence no heart beat. Thanks for the reply though. I have no idea what a PQRST is, but it sounds good thus far.
justaboutpastitIcon...04-08-2015 @ 22:16 
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Post Edited: 04.08.2015 @ 22:50 PM by justaboutpastit
PQRST is the cardiac cycle.

http://www.emergsource.com/?page_id=90

I think the bypass is set a certain pressure in order to get the blood around the body much the same as a persons blood pressure.

if someone flat-lines it means the heart's electro-conductivity has stopped and therefore the heart cannot pump the blood around the body. you can simulate the heart in this case via the machine.

like wise giving chest compressions pumps the heart in a cardiac arrest. however just because someone has a cardiac arrest does not mean they have flat-lined. in most cases the heart's electro-conductivity is miss firing and needs to be reset which is why they use the de fib to shock the heart (stop it) and then it hopefully restarts in a normal rhythm

Please note I may be very out of date with this info its been some 15yrs since my medic training
Funky_monkeyIcon...05-08-2015 @ 13:16 
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justaboutpastit said:PQRST is the cardiac cycle.
"....however just because someone has a cardiac arrest does not mean they have flat-lined. in most cases the heart's electro-conductivity is miss firing and needs to be reset which is why they use the de fib to shock the heart (stop it) and then it hopefully restarts in a normal rhythm"


Yes, it just flutters and doesn't fire properly. It often doesn't flat-line completely when they are in atrial fibrillation. The term "defibrillate" is just to get it out of this er... fibrillation!

"Fibrillation - make a quivering movement due to uncoordinated contraction of the individual fibrils." < O.E.D.
little_aIcon...05-08-2015 @ 14:28 
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Is there any kind of medical procedure outside of a Soviet kennels that would entail someone having their heart removed completely, surgically corrected then reattached, or is Brian talking bollox?
EDCLARKEIcon...05-08-2015 @ 14:56 
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little_a said:Is there any kind of medical procedure outside of a Soviet kennels that would entail someone having their heart removed completely, surgically corrected then reattached, or is Brian talking bollox?


I know nothing about any medical procedures , but I strongly suspect Brian is talking bo***cks .
Funky_monkeyIcon...05-08-2015 @ 15:14 
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I think it's been done. They've done heart transplants before. All you need is fresh, oxygenated blood going in, and de-oxygenated blood taken out.
BillytheoldIcon...06-08-2015 @ 13:26 
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I had something to say but images of the Tin Man on the Wizard of Oz is there beating his tin chest. It seems odd separating the head from the heart.
aaron_lohanIcon...06-08-2015 @ 13:49 
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little_a said:Is there any kind of medical procedure outside of a Soviet kennels that would entail someone having their heart removed completely, surgically corrected then reattached, or is Brian talking bollox?


If Steve Turner can have a second pancreas then someone can have their heart removed completelyHappy
McMuffin_GainsIcon...06-08-2015 @ 14:15 
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Post Edited: 06.08.2015 @ 14:34 PM by McMuffin_Gains
Funky_monkey said:
Yes, it just flutters and doesn't fire properly. It often doesn't flat-line completely when they are in atrial fibrillation. The term "defibrillate" is just to get it out of this er... fibrillation!
"Fibrillation - make a quivering movement due to uncoordinated contraction of the individual fibrils." < O.E.D.


A little off topic, however...

It is one of the most misunderstood concepts going, generally thanks to TV - Suddenly the monitor goes 'flatline' there's no pulse and they just run in with the paddles and BOOM shock them back to life...wrong haha.

For a 'Defib' (Defibrillator) to work there MUST be some electrical activity in the heart already, the most common rhythm to end up in is ventricular fibrillation, essentially the heartbeat has stopped and as funky says the heart is just quivering although still doing something, it is not 'flatline'.

We have AED's at work (Automated External Defibrillator) and they are fantastic! If someone stops breathing and has no pulse the chances are it's Ventricular Fibrillation. The Defib can bring someone out of VD but cannot shock someone back to life as seen on TV. You use the Defib alongside normal CPR. The chances of saving someone with just CPR are as little as 4% - add a defib into the mix and those chances shoot to around 70% (if i recall correctly). They are such a great tool, been automated, you don't even really need to know how it works, just whack the pads on and press the 'shock' button when it tells you to.

In real life if someone 'flatlines' and the heart completely stops the only thing that will save them is CPR and IV drugs to encourage the heart to restart.

This video shows an AED in action, one of the best inventions ever for first contact medical care:

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