The current passed through two "metal spoons" and hit the boy's naked heart. After 3 hours, he woke up

Outside the house, the wind and thunderous masterpiece, the monsters of the corpse crushed block were lying quietly on the experiment, a lightning cut through the dark sky hit the monster. It's right.

The plot above comes from the science fiction "Frankenstein", which is adapted into hundreds of movies and dramas. When the author published a novel in 1818, he must not think of it. After more than a hundred years, the use of electric shocks to "return to death" will become an essential skill for ordinary doctors.

Monsters composed of corpse blocks are returned to life after electric shock | Frankenstein

3 -year -old girl who crashed window

First attempt

Now we know that appropriate electric shocks can help the heart return to normal beating and save life at critical times. However, people's attempts on electric shocks started when they did not stabilize the power supply.

Electric has always been considered magical power. The first container that can store electricity appeared in 1745, which is Leyden Jar. After people learn to store static electricity and control discharge, they can't wait to start exploring electricity, including using electricity for the human body.

For the first time, the electric shock of "resurrection" occurred on July 16, 1774. On that day, Catherine Sophia Greenhill, 3, fell off his window sill, and the doctor announced that there was nothing to rescue. So, Mr. Mr Squires, who lives across the street, tried the electric shock after asking the child's parents' consent. At this time, it had been 20 minutes since Catherine.

The electric shock device published by the magazine in 1792 is similar to the | references used by Mr. Skels [1]

Squels moved the device to stimulate all parts of the girl with electricity. At the beginning, it had no effect, but after the electric shock, he touched the weak pulse. After a while, Catherine began to sigh, and then gradually recovered his breath. After about 10 minutes, the girl vomited, and the consciousness was a bit vague after that, but it seemed to be fully recovered after a week.

This may be the first successful case of cardiac vibration in history. However, it is also possible that the girl's heart is not wrong, but the head is traumatized, and the electrical stimulus just awakens her from the coma.

This "resurrection" is just a courageous attempt to hit the luck. No one knows how the key parts of the electric shock and how the electricity is effective. In addition, the generator was not invented at the time, and people did not even have stable electricity.

Electric shock to calm the heart down

But you can't start it

After being awakened by Catherine for a hundred years, practical generators appeared, and people began to use electrical lighting and production. While obtaining convenience, there are more employees who have died unexpectedly, but doctors do not know the reason for the death of electricity.

By 1887, Augustus Desiré Waller, a British physiologist, recorded the human ECG for the first time. Since then, scientists have gradually understood the heart of the heart to be beating: the normal heart is like a group of bosses regularly (automatic discharge of sinus knot automatically), and order to pass through the leaders of all levels (the conduction bundle transmits the electrical signal to the heart to the heart. Everywhere), tens of billions of employees squeezed a giant water ball and pulled away (myocardial coordination shrinking and diastolic) after receiving the order, pumping the blood out of the heart, so that it provided nutrients and took away the circulation of the whole body and took away it. waste.

Normal heart activity | Medmovie

Subsequently, doctors recorded abnormal ECG, and then combined with animal experiments, there were two main mechanisms for human pulse to disappear and death. One is that the heart suddenly quiets down and completely stops discharge. ECG becomes a straight line, which is equivalent to the bosses faint without order. All employees stop working, the blood no longer flows, and quickly leads to death.

What is more common is the second kind of heart restlessness (ventricular tremor). The place where the place should not be discharged is discharged. Similar to the employees who do not listen to the boss's order, they push the water ball at will. Due to the large number of employees and the huge water ball, the uniform thrust can only tremble the water ball without obvious drainage, the heart cannot promote the blood, and it will be completely quiet in a short time.

The ventricular tremor, the heart cannot promote the blood | Medmovie

Both situations make people's life hanging lines. When rescue, you need to use external forces to replace the heart contraction, try to maintain blood circulation as much as possible, and reduce ischemia damage in the brain and other organs. For a quiet heart, the sinus boss woke up or the new boss settled in (implanted with the pacemaker) to jump again.

And a calm heart, might be able to return to normal. In 1899, two physiologists at the University of Geneva found in the experiment that after the electric shock caused room fiber, a stronger electrical stimulus could terminate the tremor and allow the dog to return to normal heartbeat.

This is because when the heart is trembling, the electric shock allows the entire heart to pass the electricity at the same time (myocardial deodorization), that is, let everyone pause it, and then I look forward to the boss regaining the power of the whole heart and restoring the normal heartbeat. However, the electric shock can only be restarted by the effect of calming the heart.

Therefore, when someone is found to be disappearing, it is the most important thing to maintain blood flow with the chest. You can try electro -tremor for restless hearts, and the quiet heart can no longer calm down. Electricity is useless. The shock of the "starting death" picture can only appear in film and television dramas). Boys open their chests

The first real heart shock

Seeing that the electric shock allowed the dog's arrhythmia to return to normal from ventricular fibrillation, doctors began to find opportunities to use electricity to rescue humans on the edge of death.

It is more likely to encounter the operating table, especially the chest surgery near the heart. As a heart chest surgeon, Claude Schaeffer Beck has encountered this situation many times. As of 1947, his Western Conservation University School of Medicine has tried 5 heart electrical electricity on the operating table. Audibular, but none of them woke up, and all patients died soon.

Dr. Beck did not disappoint the expectations of electrolytes and made the sixth attempt on a 14 -year -old boy named R.H.. The boy suffers from severe congenital funnel chest, and the nearest distance of the sternum distance is only 2.54 cm. Because the heart and lungs were squeezed, he felt unable to breathe during exercise. Dr. Baker's income was to perform sternum removal surgery.

In recent years of funnel chest cases, deformed sternum squeezed the cardiopulmonary | references [6]

On the 6th day after admission, the boy went to the operating table, and his sternum was removed smoothly. However, when the doctor closed the chest opening, the boy's pulse disappeared suddenly, and the blood pressure could not be measured. It looked like it was. The doctor quickly opened his mouth, opened his chest and saw the heart trembling. He immediately massaged the heart with his hand to let the blood flow and injected a strong heart drug, but did not respond.

In the next 35 minutes, the doctor has been doing heart massage and maintaining the boy's breathing with a ventilator. During this period, the electrocardiogram has been showing ventricular tremor. After the defibrier is ready, the doctor placed the two spoons of electrode plates directly on the boy's heart and made the first electric shock. The tremor still did not stop.

Dr. Baker and his heart tremb | References [1]

The doctor used the drug with stable arrhythmia and shock again, and the heart of R.H. The heart suddenly stopped. Next, a weak, regular and frequent contraction appeared. The heart massage continued for 5 minutes. After that, the shrinkage became coordinated and powerful.

After R.H. Cardiac coordination beating for 20 minutes, the doctor closed the wound of the chest again, and then removed the tracheal intubation, and the boy started to breathe himself. After one or two hours, blood pressure gradually returned to the level before surgery.

3 hours after deflation, the boy had woke up and could simply answer the question. After the operation, the boy's heart and brain were operating normally. The kidney function was affected by ischemia for a while, but it was recovered a week or two, and eventually discharged from the hospital on the 31st day of hospitalization. When we came to review 3 months after surgery, the boy said that he was no longer so breathing when he was in activities, and the electrocardiogram of the review was basically normal.

R.H. is the first case to fully recover from the long -term ventricular fibrillation, and the first time the cardiac electrostatic fibrillation has been successful in humans. Dr. Baker made a suggestion that the operating room should be equipped with electromotive defibrillation devices, and medical staff must also receive training in electric shock operations.

This successful case promotes the rapid acceptance of electrical fibrillation around the world, but it obviously has a major disadvantage: the electrode board needs to be placed directly on the heart, unless it happens to be in the chest opening surgery, the cost of opening the chest for electric shock is too much. It's too late to implement it.

Speed ​​up 10 times to live discharged from the hospital

You can also open your chest

In order to give more people the opportunity to be "resurrected" by electricity, electrical engineering scientists have developed an in vitro defib with the in vitro of the skin that can be placed on the skin without opening the chest. Electro -cutting experiment. Because the current penetrates from the chest skin to the heart, some doctors are worried that the electric shock effect is not good and may cause damage.

Paul Maurice Zoll, a heart disease expert, believes that this new method is worth trying and contact an electrical company to customize a instrument. After his bass Israel Hospital conducted in vibration of 4 patients, Dr. Dr. Zhuor published a report to summarize:

The first was a 64 -year -old woman who appeared in ventricular fibrillation after acute myocardial infarction. After receiving the in vitro, the ventricular fibrillation stopped immediately, but the heart was still, and the pacemaker failed to drive it. The second was a 78 -year -old man. He had no consciousness for half an hour when he arrived at the hospital. The electric shock resumed his slow heartbeat, but after a few seconds, he turned back to the ventricular tremor. The doctor repeatedly shocked 6 times, and he still did not keep him.

Dr. Dr. Zhuer and the in vitro-in vitro defibrier | Harvard /Wood Library-Museum

On November 17, 1955, the third patient was admitted to the hospital. For the time being, we called the 67 -year -old man who did not leave the name as Mr. A. He began to have a full -body convulsion almost every week ago when he was sent to the hospital. The doctor did not touch the pulse. The electrocardiogram showed that the heartbeat was often suspended and the heart rate was very slow. The doctor settled the pacemaker to drive his heart when the heartbeat was too slow.

On the evening of December 4, Mr. A had a sudden twitch, his breathing and pulse disappeared. The doctor immediately pushed the bulky in vitro radon, painted the two copper electrode plates, pressed on the chest, and kept other medical care away from the electrode and the patient. Essence The ventricular fiber did not stop, so the doctor raised the voltage and tried 4 times in a row. Mr. A finally recovered the previous slow heart rate 7 minutes later. Combined with pairing treatment, he woke up. Next, Mr. A repeatedly occurred on the 6th and 11th. After 5 electric shocks, the abnormal heartbeat was terminated. After that, the abnormal arrhythmia gradually decreased. He did not twitch again, and he felt good about getting out of bed. In order to go home for Christmas, he insisted on being discharged from the hospital on December 20th. After 3 months of review, everything was good.

Some people can fully recover after so many shocks, which not only proves that the external electric shock is effective, but also indicates that the body function is not obviously damaged. After that, this more convenient electrocalypse was gradually adopted by hospitals.

However, in this report, the fourth ventricular patients still did not rescue. In 1956, the 63 -year -old man was admitted to the hospital for drug poisoning. The ventricular fibrillation stopped after the electric shock, but his heartbeat was slow and weak. After the drug, electric shock and pace treatment, he still died quickly.

Medical attempts are often like this. Occasionally successfully succeeded in repeated failures. The doctor summarized experience and improved methods to gradually improve the success rate. Researchers have continued to explore for many years for the best way to operate cardiac vibration.

Today's defibrillator | wikimedia-eastl

Smaller, lighter, more convenient and timely

But the opportunity is still fleeting

To this day, there are still hundreds of thousands of people in my country every year in China, and the number of people has not reduced the trend, but the method of response has gradually increased.

Before the ventricular fibrillation, doctors will deal with heart diseases that are likely to cause ventricular fibrillation, and try to control them with drugs or surgery. If it is treated, the risk of ventricular fibrillation in the future is still very large. Doctors may recommend implanting implanted pericotly ribs (ICD) into the chest skin in advance. This headset box -sized instrument can be found in time, and automatically shocks by the wires placed in the heart, which is equivalent to carrying Dr. Baker's defibrillation instrument with him.

If there is no warning and a sudden intercourse, medical staff can use an external tremor to shock like Dr. Zhuer. The current defibriloger is smaller and lighter, and one hand can be carried up, and the electrode plate has become a more convenient iron shape.

Even if there are no medical staff around them at the occurrence, passers -by trained can use an automatic vitro -based tremor (AED). AED is usually placed in public places such as the airport station. Passers -by only need to stick the electrode to those who need to be rescued according to the figure. The instrument will automatically identify the heart rhythm, discharge and prompt the next processing. The instrument is simple to operate, and the pasted electrodes can also reduce the risk of electric shock.

Automotive outer tremor (AED) | pixabay

However, the cause of many arrhythmias is still unclear, and the treatment effect is not always satisfactory. Because the treatment window of ventricular fibrillation is very short, every 1 minute delay in defibrillation, the success rate is reduced by 7%to 10%, and the success rate of the rescue of ventricular fibrillation in my country is only about 5%. With the development and popularization of technology, the chance of saving success in the future will gradually increase.

Looking back at the development of defibrillation technology, from the first -time shock to all doctors, all doctors will use the defibrillation instrument to "return to life". The courage, Mr. A, R.H. and every rescue loser, and the understanding and support of relatives and friends such as Catherine's parents and other patients.

references

[1] Cakulev I, Efimov IR, WALDO AL. CardioVersion: Past, Present, and Future. Circulation. 2009; 120 (16): 1623-1632.

[2] Ball CM, Featherstone Pj. Early History of defibrillation. Anaesth intenSive Care. 2019; 47 (2): 112-115.

[3] Chaikhouni a. The Magnification Center of CardiothorAcic Surgery Part 8: Reviving the dead. Heart views. 2010; 11 (2): 85-91.. 85-91.. 85-91. 85-91. 85-91.

[4] Beck CS, Price HS. Ventricular Fibrillation of Long Duration Abolished by Electric Shock. J am Med assoc. 1947; 135 (15): 985.

, A., Ghionzoli, M., Messineo, A., POLITI, L., DIVISI, D., Gonfiotti, A., CRISCI, R. PECTUS Excavatum in Adolescent: The Nuss Technique.

[7] Chinese Research Hospital Society of Cardiopulmonary Revisive Professional Committee, Science Popularization Branch of the Chinese Medical Association. 2018 China Cardiopulmonary Revisive Expert Consensus. Chinese critical illness and first aid medicine. 2018; 30 (5): 385-400.

[8] Chinese Research Hospital Society of Cardiopulmonary Revolution.

Author: Dai Tianyi

Edit: Odette

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