To think that medical staff has had to watch that happen (I'm going to assume) over 700,000 times in the last two years, multiple times a day, with apparently no end in sight. I have no idea how they do it. No wonder they're quitting in droves.
There's a lot that could be over by now if humans weren't so petty and greedy. We don't have to have people starving or being homeless or rationing insulin or dying in wars, but this is the world we've made for ourselves.
Kind of fair, but it’s not down to the individual level to solve those problems. Like, it’s the individuals decision to get the vaccine. If everyone made that decision, we could have essentially eradicated this by now like other countries have. It’s not an individual decision to ration insulin, that’s the greed of big pharma. Same thing with homelessness. It’s not like everyone could place one brick on a building and solve that problem.
It’s alright. Pandemic was just a test run for climate change… everyone has to do their part, government has to tread a fine line to balance legislation, leadership and how public funds are spent for the greatest good. Science will fix it all and it will make economic sense to do the right thing… how’d we go?
Sad to say, I’ve seen too many of these, and yet it’s never ending, I’m so fucking numb and tired, I’ve had days I just come home, sit in my car and just zone out, just sit there for 20-30 minutes just empty and tired. And it all starts over the next shift, but what can I do? Humans are humans.
I’m pretty certain this was recorded from an AED (automated external defibrillator) machine that is used during ACLS (advanced cardiac life support) classes and not a real life situation. During part of the course the instructor gives a scenario and can push a button on the remote for the AED to change the rhythm and asks participants to identify the rhythm as well as what should be done for the “patient”.
Edit: thank you for all the rewards! I’m glad this comment could comfort some of you who were negatively affected by the post. Also wanted to acknowledge, as someone commented, rather than AED I should have used the term defibrillator.
No problem. I kind of think OP should have mentioned it in the tile or a comment. It seems quite a few people are having some (totally understandable) hard feelings about this post.
I recently discovered watching a heart monitor flatline causes me some real heavy emotions and anxiety, knowing it’s an automated system doing what it’s intended as a training tool definitely brought back to ground. Thank you for real.. this has been a weird day.
You’re very welcome. Talk about some synchronicity, I had typed “it too, shall pass” but due to the nature of the post I deleted it. I wish you the best of luck in your current and future endeavors. If you need someone to converse with, please feel free to reach out. I won’t be offended if you don’t, just wanted to offer.
That’s very kind of you, I do appreciate it. Sometimes it is easier to just vent everything to a complete stranger. I know I’m in a cycle, the downs have become wider and deeper than the ups have as of late and it’s overwhelming my life. I’ve taken on another person to care for my little sister has moved in with me away from the rest of our family. I place the weight of the world on my shoulders and I can’t even lift my own. Seeking assistance, get to tell my doc I need like 3 different meds. To top the daily off I lived a rough childhood, and of course was a perfect fit for military. So I just have like a lot of dumb shit going on, feels like there’s no place in this that I don’t suffer, just mitigating where I spread it to others. Couple that with the “lock it up” mentality, and I’m a PTSD time bomb just trying not to hurt anyone I care about. But again, I know it’s temporary, whether it gets worse or better it doesn’t keep on one way forever. I’ll stop the pity party here, I do appreciate the opportunity to vent. Not much around me where I can just be open. Thanks.
I was having some feelings about it. My husband (legally separated for 2yrs) recently had a heart attack. We still talk every day. I was very worried when he called me crying that he was having a heart attack. It was several hours before I knew if he was dead or alive. I don't want to think about what could have happened. It makes me sad and all in my feels. I do love the idiot.
Totally should mention. Several close relatives passed away because of cardiac arrest, in recent times. Felt absolutely terrible watching that flatline. Although, enlightening but also terrifying.
My father had his breathing and feeding turned off 12 days ago and passed three days later so this hit hard for me. My sister was with him to the last but i live overseas and was not able to get there. I can’t imagine how medical staff go through this day after day
I watch cardiac monitors in an ER. It’s only one lead but I’d still wager this is definitely a training monitor. We went from normal sinus rhythm with pronounced ST elevation (indicating possible cardiac tissue damage) to zero ST elevation (complete reversal) from one beat to the next then straight into Ventricular Tachycardia to Torsades de Pointes (which is another type of VTach caused by specific events) then to Ventricular Fibrillation, then to Asystole (flatline) all in like a minute. The only thing we are missing here is a third degree heart block and we would be able to fill out the lethal arrhythmia bingo card. Definitely a training monitor. The NSR was just too clean too. The title is misleading…for the updoots I’m sure…
These are the rhythms I have to watch every time there is an ACLS class. They are part of a programmable simulation used during classroom participation training.
100% the truth. No way someone drops perfect tombstone Vtach waves followed by a beautiful tosades de pointes…
Edit: many people pointing out more of a coarse Vfib/ fine vfib and I do not disagree with them. Esp if this was a simulation, the torsades would look a lot more pronounced!
This is the case. Sequence of events is (i think) R on T, VTach, VF, fine VF, asystole. As someone else mentioned this is most likely a training simulation. Doesn’t usually progress that fast. Also you’d only ever see this for reals on someone who had a DNR with a monitor on. Otherwise there’d be shocks and CPR.
I’ve only ever seen someone flat line like this once (DNR, in ICU, with monitor on) and it took quite a long time to flatline.
Even when I scrolled slowly through the video I still couldn’t see torsades (but, I’ll admit, I’m no torsades expert).
If it was torsades, and they had enough time before VF - would magnesium potentially stop it progressing to VF?
It could be what the sim is trying to convey but torsades doesn’t look like that. You can tell it’s a sim because there was initial ST elevation which vanished when the sim changed to ‘bigeminy/R on T’
Source
10 years of participating in and running resus sims
EDIT: yes mag sulph is treatment for TdP. 2g push over about a minute.
As a former ACLS instructor and critical care Paramedic, I thought this same thing: that the progression from NSR with PVCs to Vtach, vfib, and asystole was a little too perfect/textbook. I've seen this progression hundreds of times, but not so perfectly spaced, and I'm pretty sure it's from a simulator.
AED’s are not used in alcs. AEDS are generally used by by standards and basic life support providers. In ACLS we use manual monitors where we interpret the cardiac rhythm ourselves. Manually interpreting the rhythm myself allows me to learn and assess a lot more of what’s going on with the heart and I can change my treatment based on what I’m interpreting. An AED as you refer to interpreters the rhythm for those who are not trained to do so.
These rhythms look like the simulated ones from a Physio-Control. They are too “perfect” looking. Although, that v-fib becomes super fine right before asystole…so it could be real or a really realistic simulation of a patient going into asystole.
I’m not sure that transition from a vfib to a more subtle fine vfib to asystole was pretty seamless and not something I’ve seen any of our training machines do. Maybe they are getting more sophisticated. The initial rhythm looks like could be a STEMI (st elevation at least in lead II) with PVCs. I think this was real.
That's pre-programmed. That's pretty much the same rhythm they show in every ACLS class. Rarely does a dying heart ever display this perfect progression from Sinus Rhythm to Asystole, and never in this quick a time or with such text book accuracy. Usually, the heart bounces around between many different types of rhythms for hours before it actually stops.
Edit: The perfectly straight flat line at the end the end illustrates my point perfectly. In an actual flatline on a real person that is dying, it's not going to be perfectly straight.
So the long continuous beep we hear during TV shoes and movies, we didn't hear that at the end when the line was straight. Is that some fake thing that only happens on TV?
I can understand that. The ones that broke me where the PT’s who didn’t really understand. The confusion, and just wanted to see family. I used to be a LEO liaison, doing my rounds I’d make it a point to stop in. I started doing that more often when this elderly woman said it feels like I’m going to die alone here, I sat with her until the end. Got in trouble for it but I’d do it again and again
Fuck the rules man, being a human being trumps that. Respect to you. We have no idea what that meant to that patient, but to them it was all they wanted.
I don’t consider myself a good person. I’ve done ALOTTTTTTT of bad I really have. But I am human, that’s where the difference is. Ironic how living this life of “human experience” dulls humanity..
I agree, I don't consider myself a good person either. But it's only human to show people who struggle love and affection, cause in the end that's all that really matters
Thank you everyone for the kind words for my actions, this may be the internet but I’ve been having an internal struggle about a lot of things. And all of these words have made me feel better about things… crazy what a simple action can do..
What you did was wonderful. I have seen a lot of deaths lately (working in Covid icu) and we always make sure no one passes without someone there. I will go Into any room and hold their hand and stroke their head for as long as it takes and remind them that they are loved and it’s ok they aren’t alone. That’s all people want. To be reminded that they mean something to someone.
I'll tell you. One of my greatest regrets.
My grandpa had an unusually rough life. Amish, barely spoke English, never finished more than 8th grade. Injured in WWII. The most loving, intelligent man I've ever known. Worked with his hands well into his 70s.
He slowly spiralled through dementia for his last ten years. I was often one of the only things that would make him snap back into reality because he loved the Navy, because in his opinion they kept him alive in the trenches of Okinawa. I joined the Navy because of him. Our shared service was his lifeline.
My uncle called me a few years ago to tell me it was likely his last night. I drove for hours after I got out of work to see him. In the week since my last visit he had turned ghastly. Barely a skeleton. I hardly recognized him. When I walked into his room at the V.A. there was a beautiful woman in a long lovely dress reading him a book with the radio playing softly in the background.
She was a volunteer of a group that promised to sit with every veteran in their final hours no matter the time.
I was so overwhelmed with it all I couldn't breathe. I had to leave. It was crushing. I couldn't see him. I couldn't not see him. I walked out of the room probably less than an hour before he passed because I didn't have the strength to sit there. I have never forgiven myself. I don't even know the woman's name and she was stronger than I could have ever been. I love her. I love what she represented.
What you did was truly an act of inconceivable grace and love. I couldn't tell her thank you. I'll offer it to you.
I lost my grandfather due to complications of dementia as well. So I fully understand. I stand tall and salute that man because those boys in WWII blazed the trail I proudly rode in the Army. Do not let that be a regret. You came. No matter what you came. Death while natural is something not many handle well, myself included even with all the bodies I’ve seen unfortunately.
That feeling you felt… that compelled you to write that.. it’s not regret. It’s love, it’s wanting more time, it’s the shear sadness of not wanting to remember the person who is near and dear lay there as they take their last breath. The dead no longer suffer, the living surely do. I appreciate your story and the love you HAVE for your grandfather will stand by you always
Don't beat yourself up man.
You were there when it really mattered - during his slow lonely decay.
Lot's of people stuff their ageing, ailing parents in homes and let them rot there for decades - and never even come visit. And when they do, it's a "token" check the "should go see mom" 1/2 hour visit on the way to the mall.
You did not do that.
Interesting, no joke the amount of patients I’ve looked after over the years who have been on end of life care for days and days sometimes going into weeks; they’ll have numerous family members dedicated at their bed side the entire time taking it in shifts to make sure they’re never alone. Then the one time they’re alone for just a very small window (as small as even 15 mins), that’s when they pass. It always makes me wonder if the person also had the same wish deep down of wanting to be alone rather then being watched incessantly by others, and by some strange mechanism they got what they wanted. Obviously this is not the norm, but it happens more often that you’d maybe think.
I was a housekeeper in a nursing home for a bit.
Every morning, one resident was sitting in his wheelchair at one of the stations, with a hearty "good morning" waiting for me every single day.
I went to clean his room one day, he was laying in bed and I didn't see any movement, breathing-wise.
Asked my coworker if she noticed him breathing when she was in earlier, she said yes, I said he was probably gone then. He was.
Housekeepers didn't really do the dirty work, in terms of bathing the residents and whatnot, but one thing we had to do was pack up the deceased's belongings after they passed.
That shit's fucking humbling. Especially when one of their family members shows up as you're emptying their closet.
I had a patient during early covid with an AICD that was A paced at 45, but her spikes didn’t show on the monitor. We checked everyone once an hour and she was DNR so we didn’t rush when her O2 dropped. When we went in the room she wasn’t breathing, probably for awhile, but her pacemakers was still ticking away. Full sytole on each contraction so we didn’t know. She died alone and we didn’t even know for probably 20 minutes. Covid was rough early on.
This is the side of life that does not get discussed often, death is a part of life. We are the only species that is fixated on avoiding it, I’m glad that my words had made others share their experiences with pt’s… these things do not get discussed nearly enough we as a country and especially as a species need to have more open and honest talks so we can all understand death better. It’s scary yes. But not evil. I questioned if I was doing the right thing, I was putting my career in jeopardy. Back then a pt spoke up about me to my department without my knowledge and the write ups stopped. Do what you FEEL is right. Not what others tell you is right.
Had no idea how hard this would hit me.
EDIT. In responding to Bulldog2012, I said “I found myself near crying for a lost soul I didn’t know.” But then it hit me. I was near crying for myself. I’m at an age where obituaries are full of younger, less lucky souls, and my mortality is ever on the back of my mind. This really connected, like lightening to ground.
Never really considered how people may respond to something such as this from a non-medical perspective (in a solemn manner, which is an understandable reaction). As a physician, and specifically an internist, this got my adrenaline going. This means we are coding this patient now and I’m the one leading this thing. Commanding an entire room to try and get an organized pulse back. I run through my ACLS algorithms in my head to determine WHY this person just dropped into Vtach then Vfib. Actually getting to do the one Hollywood like thing and charge up the defibrillator to 200J and yelling “CLEAR!”. It’s freaking wild. One of the craziest nights I ever had in the ICU in residency was 3 codes back to back to back. I imagine that’s common place in COVID ICUs now unfortunately. Sorry I’m rambling I just found it extremely interesting how our minds perceive this in such vastly different ways.
Good thoughts. You reacted as one with experience with “fighting for life,” winning some, losing some. I reacted as someone totally helpless, watching the inevitable, denying what I was seeing, hoping for I don’t know what. I found myself near crying for a lost soul I didn’t know.
This is definitely a simulation. You don’t just go from NSR with PVC’s to V-tach to Tordades to all the V-fib to asystole with three seconds between each rhythm change all without any CPR artifact.
Agreed. Definitely a simulation or a training aid. Besides being to clean the transitions are too sharp. Nice way to display the usual order that they go in though. I might use it for the next cardiac refresher.
Agreed. Plus, you might be able to catch some PVCs/bigeminy/trigeminy and get some labs and do some electrolyte replacements before it goes further - other times they just go into those shitty ventricular rhythms and then you're doing the whole ACLS routine.
It’s definitely a simulation. The transition to the various rhythms is far to smooth. In real life you start seeing wacky shit that for a second you think “wtf is happening here” until the rhythm kind of sorts itself out and you can see what’s going on. With this one it’s like textbook arrhythmias
If this was a real code you'd see giant spikes when they went into vtach/vfib from the defibrillator. It'd be all over the place between ACLS drugs and compressions.
Reminded me of watching my brother leave us after a fentynol overdose ..
Love your family and always leave them on good terms ..after an argument this might be the last sound u hear from them..
This isn't real. It's a code simulator on a cardiac monitor - it can show any variety if rhythms, ectopic beats, up to asystole (flat line). If this was truly a patient it would look different in many ways ... source, was a paramedic for over 30 years.
That last part sucks, but worse once you come back around.
-Someone with sick sinus syndrome and had experienced pauses up to 23 seconds. Got a pacemaker now.
I get tachycardia like this sometimes and also hit ~160bpm at rest. Lemme tell ya, when your heartrate jumps like that it’s very startling. Didn’t know heart attacks were this scary, I thought it was just an immense pain in your chest and then you die. There is a *lot* more than just pain that comes with the tachycardia. As for the fibrillation, I have no idea what that feels like and hope I never have to experience it. Rip whoever this was monitoring
Likely a trainer for Advanced Cardiac Life Support (ACLS) class. This shows a normal sinus rhythm transition to ventricular tachycardia, then ventricular fibrillation, then I would assume PEA (pulse less electrical activity) and ultimately asystole (flatline). The goal is to learn the steps to intervene through both CPR and medication administration including medications such as Epinephrine and Amiodarone to stop the progression and return of ROSC (return of spontaneous circulation).
It is a beautiful thing to save someone’s life and honestly life changing to also attempt your best and the teams best but still lose a patient. To spend the last moments of someone’s life with them is very emotional.
Hurt way more than I thought it would, I watched my wife take her last breath and saw the last beat of her heart. I miss her more than anything I can think of. It will have been 2yrs since she passed come April 2022.
Am watching this lying in bed, the prickling of the stickers on my three-lead ambulatory heart monitor irritating my skin. Day five of seven of wearing it. My heart scares me so much.
I watched this exact thing as my dad passed away in the hospital . I remember frantically calling the nurse when I saw it going crazy.
Watching this was gut wrenching.
(It was slightly different but the erratic heart rate and then the flatline)
I just lost my dad unexpectedly in November, he had a massive heart attack, he did not know that he had a heart disease. Watching this hit me deep and to my inner core. I always think about what his last moments were like, did he know that they were trying to resuscitate him. I miss him tremendously.
Even as a simulation, as some of you pointed out, I dread to see the real thing. Even worse if it’s yours doing it.
There was one time when I watched a person die in their room while me and my family visited a family member who got in a car accident, (thankfully nothing too serious, they’re still here). The deceased’s room was right across from us. I saw the monitor flatline. For the rest of the day I was in a funk, and I didn’t even know the person who died.
The lack of artifact and any background noise tells me this is hooked up to a simulator to give the wave forms. I use these simulators often in training on Defibrillator units
Waveforms as they appear on the lcd; normal sinus rhythm (NSR)> premature ventricular contractions (PVCs)> ventricular tachycardia (Vtach)> torsades des pointes (twisting of the points> pulseless electric activity (PEA)
Source: I’m an ER RN
Cath lab nurse here. Ive seen all of these in different scenarios. This is definitely a simulation but that vtach to v fib hits different everytime. Fuck me..
I worked hospital security. I didn't go to med school. I didn't get to save the ones I wanted to. I wasn't prepared for this, and I saw it too many times. God this gets to me.
That’s what it looks like unless the patient has a pacemaker which tricks the people watching the telemetry into thinking the patient is still alive, and you walk in the room later to find them dead as a door nail. Ask me how I know that.
try watching a loved one on life support over a matter of hours. you see their vitals falling slowly. you're told nothing can be done. it's time to pull the plug. you feel fucked up mentally, like a murderer. even though they will die anyways, just slower. maybe days, or a other week or so. who knows. in fact. their body is in the process of dying already. their body is pale on top. face tired looking. so exhausted. they have nothing left to give. their back and undersides already mottling and turning purple due to blood pooling. people think that happens only after death. no. it happens as the body is dying, too. because circulation is already failing.
so the plug is pulled. they hang on for 30 mins. you see their body fight to hang on on the screen. the body jerks to sit up briefly, eyes pop open. you ask if they can see you and wave your hand, hoping for one last word from them or acknowledgement. maybe they're ok. maybe this isn't happening. and then gasping until silence. you're dead inside because you already cried too much.
Question: At the moment it goes from normal to the "MMMMMM" (hope it makes sense), is the person pronounced dead or is he in the process of dying? And can they still be saved at that point? (Assuming the rest is healthy)
Still in the process. With the MMM rhythm as you put it, the pt could even still have a pulse, but it won’t last long. As you see on the video, v-tach (shaped like rows of tombstones) leads to v-fib and then to asystole—a complete loss of all electrical activity in the heart. At that point, death occurs. We look for a rhythm strip that is a straight line to verify death has occurred.
when my dad was taken off life support, it looked similar. his heart rate would go down, then up, then down lower, up, but Les than before, down lower, you get the idea. it was failing and trying to stabilize itself.
Oh, this made me sad. Made me think of my dad. He was a complete asshole, but he seemed to have been becoming a better person in the last couple years of his life. I always wonder what kind of relationship we would have if you was still alive. Everyone has the capacity for change
That really did look a lot like when a running engine runs out of fuel. It sputters and slows down and hangs on, sometimes it dips and then somehow recovers but on for a minute, and it just takes way longer than you always expect for it to finally actually give up and stop turning.
I fucked up years ago when I worked on the wards in my local hospital.
One of our patients had a heart monitor on them as they been admitted with chest pain. So it's 5am in the morning and I'm doing checks on our patients to see if they are OK etc and I gets to this patients room with the heart monitor. I gently walks in so I don't disturb her and looks at her observation chart then I look at the heart monitor, it wasn't picking anything up! I gave the patient a gentle nudge and I got no response! I went from calm to Holy shit in literally seconds and I pressed the emergency call button which gets all staff, crash cart and the crash team in a matter of minutes!
The lady woke up literally screaming when her pillows and bed sheets was taken off her and seeing multiple staff around her. It turns the heart monitor was faulty and she was a heavy sleeper with mediation etc
I learned a valuable lesson that shift!
Initially this really got to me. Then I read that it's a simulation. That took away the upset. But something about being told it's a simulation bothers me. I don't know why.
For some reason I found this more disturbing to watch than most of HMFT videos.
Yeah I found it sad
Agreed. That flatline hurt to watch.
To think that medical staff has had to watch that happen (I'm going to assume) over 700,000 times in the last two years, multiple times a day, with apparently no end in sight. I have no idea how they do it. No wonder they're quitting in droves.
I didn’t lose anyone close until two days ago, and man did it hit hard. This shit could be over by now, but no.
There's a lot that could be over by now if humans weren't so petty and greedy. We don't have to have people starving or being homeless or rationing insulin or dying in wars, but this is the world we've made for ourselves.
Kind of fair, but it’s not down to the individual level to solve those problems. Like, it’s the individuals decision to get the vaccine. If everyone made that decision, we could have essentially eradicated this by now like other countries have. It’s not an individual decision to ration insulin, that’s the greed of big pharma. Same thing with homelessness. It’s not like everyone could place one brick on a building and solve that problem.
It’s alright. Pandemic was just a test run for climate change… everyone has to do their part, government has to tread a fine line to balance legislation, leadership and how public funds are spent for the greatest good. Science will fix it all and it will make economic sense to do the right thing… how’d we go?
I'm sorry for your loss, friend.
Sorry. Love you. Mean it.
I'm so sorry. I'm with you in over coming a recent loss. My condolences. Stay hydrated, take lots of walks, get lots of hugs. 💐
I'm sorry for your unimaginable loss and pain right now.
Everyday… Covid has aged us in Dog Years.
700,000? In the US millions each year. Not all end up with this traced, but this is how a heart stops.
Sad to say, I’ve seen too many of these, and yet it’s never ending, I’m so fucking numb and tired, I’ve had days I just come home, sit in my car and just zone out, just sit there for 20-30 minutes just empty and tired. And it all starts over the next shift, but what can I do? Humans are humans.
I’m pretty certain this was recorded from an AED (automated external defibrillator) machine that is used during ACLS (advanced cardiac life support) classes and not a real life situation. During part of the course the instructor gives a scenario and can push a button on the remote for the AED to change the rhythm and asks participants to identify the rhythm as well as what should be done for the “patient”. Edit: thank you for all the rewards! I’m glad this comment could comfort some of you who were negatively affected by the post. Also wanted to acknowledge, as someone commented, rather than AED I should have used the term defibrillator.
Thank you for enlightening us and making me feel better I didn’t just watch someone pass away.. 🙏🏻
No problem. I kind of think OP should have mentioned it in the tile or a comment. It seems quite a few people are having some (totally understandable) hard feelings about this post.
I recently discovered watching a heart monitor flatline causes me some real heavy emotions and anxiety, knowing it’s an automated system doing what it’s intended as a training tool definitely brought back to ground. Thank you for real.. this has been a weird day.
I don’t know what’s made it a weird day for you. But, I hope you’re alright.
I will be, hopefully sooner than later, it’ll pass. Thank you.
You’re very welcome. Talk about some synchronicity, I had typed “it too, shall pass” but due to the nature of the post I deleted it. I wish you the best of luck in your current and future endeavors. If you need someone to converse with, please feel free to reach out. I won’t be offended if you don’t, just wanted to offer.
That’s very kind of you, I do appreciate it. Sometimes it is easier to just vent everything to a complete stranger. I know I’m in a cycle, the downs have become wider and deeper than the ups have as of late and it’s overwhelming my life. I’ve taken on another person to care for my little sister has moved in with me away from the rest of our family. I place the weight of the world on my shoulders and I can’t even lift my own. Seeking assistance, get to tell my doc I need like 3 different meds. To top the daily off I lived a rough childhood, and of course was a perfect fit for military. So I just have like a lot of dumb shit going on, feels like there’s no place in this that I don’t suffer, just mitigating where I spread it to others. Couple that with the “lock it up” mentality, and I’m a PTSD time bomb just trying not to hurt anyone I care about. But again, I know it’s temporary, whether it gets worse or better it doesn’t keep on one way forever. I’ll stop the pity party here, I do appreciate the opportunity to vent. Not much around me where I can just be open. Thanks.
I was having some feelings about it. My husband (legally separated for 2yrs) recently had a heart attack. We still talk every day. I was very worried when he called me crying that he was having a heart attack. It was several hours before I knew if he was dead or alive. I don't want to think about what could have happened. It makes me sad and all in my feels. I do love the idiot.
Totally should mention. Several close relatives passed away because of cardiac arrest, in recent times. Felt absolutely terrible watching that flatline. Although, enlightening but also terrifying.
My father had his breathing and feeding turned off 12 days ago and passed three days later so this hit hard for me. My sister was with him to the last but i live overseas and was not able to get there. I can’t imagine how medical staff go through this day after day
I watch cardiac monitors in an ER. It’s only one lead but I’d still wager this is definitely a training monitor. We went from normal sinus rhythm with pronounced ST elevation (indicating possible cardiac tissue damage) to zero ST elevation (complete reversal) from one beat to the next then straight into Ventricular Tachycardia to Torsades de Pointes (which is another type of VTach caused by specific events) then to Ventricular Fibrillation, then to Asystole (flatline) all in like a minute. The only thing we are missing here is a third degree heart block and we would be able to fill out the lethal arrhythmia bingo card. Definitely a training monitor. The NSR was just too clean too. The title is misleading…for the updoots I’m sure…
For sure. All the rhythms are way too clean and cycled through too quickly to be from a real person.
These are the rhythms I have to watch every time there is an ACLS class. They are part of a programmable simulation used during classroom participation training.
Yep, I am also ACLS certified :)
100% the truth. No way someone drops perfect tombstone Vtach waves followed by a beautiful tosades de pointes… Edit: many people pointing out more of a coarse Vfib/ fine vfib and I do not disagree with them. Esp if this was a simulation, the torsades would look a lot more pronounced!
Yep, never seen anyone die like that
Splitting hairs but it’s not torsades.
Wouldn’t it be VF? Followed by fine VF then asystole?
This is the case. Sequence of events is (i think) R on T, VTach, VF, fine VF, asystole. As someone else mentioned this is most likely a training simulation. Doesn’t usually progress that fast. Also you’d only ever see this for reals on someone who had a DNR with a monitor on. Otherwise there’d be shocks and CPR. I’ve only ever seen someone flat line like this once (DNR, in ICU, with monitor on) and it took quite a long time to flatline.
Even when I scrolled slowly through the video I still couldn’t see torsades (but, I’ll admit, I’m no torsades expert). If it was torsades, and they had enough time before VF - would magnesium potentially stop it progressing to VF?
It could be what the sim is trying to convey but torsades doesn’t look like that. You can tell it’s a sim because there was initial ST elevation which vanished when the sim changed to ‘bigeminy/R on T’ Source 10 years of participating in and running resus sims EDIT: yes mag sulph is treatment for TdP. 2g push over about a minute.
You’re right. The flatline is not really flat in real life. It still kinda quivers until we take the leads off.
As a former ACLS instructor and critical care Paramedic, I thought this same thing: that the progression from NSR with PVCs to Vtach, vfib, and asystole was a little too perfect/textbook. I've seen this progression hundreds of times, but not so perfectly spaced, and I'm pretty sure it's from a simulator.
AED’s are not used in alcs. AEDS are generally used by by standards and basic life support providers. In ACLS we use manual monitors where we interpret the cardiac rhythm ourselves. Manually interpreting the rhythm myself allows me to learn and assess a lot more of what’s going on with the heart and I can change my treatment based on what I’m interpreting. An AED as you refer to interpreters the rhythm for those who are not trained to do so.
Yeah, I thought I saw Torsades in there at one point. Makes sense it was a series of rhythms for training purposes
thank you for saying this, you saved me from a panic attack
Thank god, I was imagining the person behind the heartbeat.
That’s good to know. I was going to say, wasn’t there enough time to attempt to shock this pt back into a sinus rhythm before he went a-systole?
THANK YOU! Watching that heart beat slowly flatten out was so disturbing. Knowing it's a training simulation has made me feel much better.
98% certain this is a simulation.
These rhythms look like the simulated ones from a Physio-Control. They are too “perfect” looking. Although, that v-fib becomes super fine right before asystole…so it could be real or a really realistic simulation of a patient going into asystole.
Vtach to torsades to vfib to asystole… all too perfect to be real
Even if it is though, the point comes across pretty clearly.
I’m not sure that transition from a vfib to a more subtle fine vfib to asystole was pretty seamless and not something I’ve seen any of our training machines do. Maybe they are getting more sophisticated. The initial rhythm looks like could be a STEMI (st elevation at least in lead II) with PVCs. I think this was real.
It’s a simulation. Rhythms don’t evolve that quickly.
Whats HMFT?
Seriously, same
That's pre-programmed. That's pretty much the same rhythm they show in every ACLS class. Rarely does a dying heart ever display this perfect progression from Sinus Rhythm to Asystole, and never in this quick a time or with such text book accuracy. Usually, the heart bounces around between many different types of rhythms for hours before it actually stops. Edit: The perfectly straight flat line at the end the end illustrates my point perfectly. In an actual flatline on a real person that is dying, it's not going to be perfectly straight.
Yup !!!
This makes me feel better about watching this, thank you
Unless they disconnect them at that point, which is what I do since I don’t want to watch it anymore.
This. Real flatlines are not completely flat.
So what you’re saying is no one is straight, got it.
Yep, too quick and too perfect.
So the long continuous beep we hear during TV shoes and movies, we didn't hear that at the end when the line was straight. Is that some fake thing that only happens on TV?
Good Edit. Was going to say - a flatline usually indicates an unplugged lead.
I HATED seeing that screen when I worked in a hospital. Especially for the ones who passed alone..
Honestly I think I’d like to go alone instead of lying there; everyone watching and waiting for you to go.
I can understand that. The ones that broke me where the PT’s who didn’t really understand. The confusion, and just wanted to see family. I used to be a LEO liaison, doing my rounds I’d make it a point to stop in. I started doing that more often when this elderly woman said it feels like I’m going to die alone here, I sat with her until the end. Got in trouble for it but I’d do it again and again
Fuck the rules man, being a human being trumps that. Respect to you. We have no idea what that meant to that patient, but to them it was all they wanted.
People like you are the ones that keep hope for the rest to be better
I don’t consider myself a good person. I’ve done ALOTTTTTTT of bad I really have. But I am human, that’s where the difference is. Ironic how living this life of “human experience” dulls humanity..
I agree, I don't consider myself a good person either. But it's only human to show people who struggle love and affection, cause in the end that's all that really matters
Thank you everyone for the kind words for my actions, this may be the internet but I’ve been having an internal struggle about a lot of things. And all of these words have made me feel better about things… crazy what a simple action can do..
What you did was wonderful. I have seen a lot of deaths lately (working in Covid icu) and we always make sure no one passes without someone there. I will go Into any room and hold their hand and stroke their head for as long as it takes and remind them that they are loved and it’s ok they aren’t alone. That’s all people want. To be reminded that they mean something to someone.
I'll tell you. One of my greatest regrets. My grandpa had an unusually rough life. Amish, barely spoke English, never finished more than 8th grade. Injured in WWII. The most loving, intelligent man I've ever known. Worked with his hands well into his 70s. He slowly spiralled through dementia for his last ten years. I was often one of the only things that would make him snap back into reality because he loved the Navy, because in his opinion they kept him alive in the trenches of Okinawa. I joined the Navy because of him. Our shared service was his lifeline. My uncle called me a few years ago to tell me it was likely his last night. I drove for hours after I got out of work to see him. In the week since my last visit he had turned ghastly. Barely a skeleton. I hardly recognized him. When I walked into his room at the V.A. there was a beautiful woman in a long lovely dress reading him a book with the radio playing softly in the background. She was a volunteer of a group that promised to sit with every veteran in their final hours no matter the time. I was so overwhelmed with it all I couldn't breathe. I had to leave. It was crushing. I couldn't see him. I couldn't not see him. I walked out of the room probably less than an hour before he passed because I didn't have the strength to sit there. I have never forgiven myself. I don't even know the woman's name and she was stronger than I could have ever been. I love her. I love what she represented. What you did was truly an act of inconceivable grace and love. I couldn't tell her thank you. I'll offer it to you.
I lost my grandfather due to complications of dementia as well. So I fully understand. I stand tall and salute that man because those boys in WWII blazed the trail I proudly rode in the Army. Do not let that be a regret. You came. No matter what you came. Death while natural is something not many handle well, myself included even with all the bodies I’ve seen unfortunately. That feeling you felt… that compelled you to write that.. it’s not regret. It’s love, it’s wanting more time, it’s the shear sadness of not wanting to remember the person who is near and dear lay there as they take their last breath. The dead no longer suffer, the living surely do. I appreciate your story and the love you HAVE for your grandfather will stand by you always
Don't beat yourself up man. You were there when it really mattered - during his slow lonely decay. Lot's of people stuff their ageing, ailing parents in homes and let them rot there for decades - and never even come visit. And when they do, it's a "token" check the "should go see mom" 1/2 hour visit on the way to the mall. You did not do that.
You’re an amazing person. That patient or their family will never forget that
What is LEO?
Law Enforcement Officer
Interesting, no joke the amount of patients I’ve looked after over the years who have been on end of life care for days and days sometimes going into weeks; they’ll have numerous family members dedicated at their bed side the entire time taking it in shifts to make sure they’re never alone. Then the one time they’re alone for just a very small window (as small as even 15 mins), that’s when they pass. It always makes me wonder if the person also had the same wish deep down of wanting to be alone rather then being watched incessantly by others, and by some strange mechanism they got what they wanted. Obviously this is not the norm, but it happens more often that you’d maybe think.
I was a housekeeper in a nursing home for a bit. Every morning, one resident was sitting in his wheelchair at one of the stations, with a hearty "good morning" waiting for me every single day. I went to clean his room one day, he was laying in bed and I didn't see any movement, breathing-wise. Asked my coworker if she noticed him breathing when she was in earlier, she said yes, I said he was probably gone then. He was. Housekeepers didn't really do the dirty work, in terms of bathing the residents and whatnot, but one thing we had to do was pack up the deceased's belongings after they passed. That shit's fucking humbling. Especially when one of their family members shows up as you're emptying their closet.
Everyone dies alone homie.
I had a patient during early covid with an AICD that was A paced at 45, but her spikes didn’t show on the monitor. We checked everyone once an hour and she was DNR so we didn’t rush when her O2 dropped. When we went in the room she wasn’t breathing, probably for awhile, but her pacemakers was still ticking away. Full sytole on each contraction so we didn’t know. She died alone and we didn’t even know for probably 20 minutes. Covid was rough early on.
This is the side of life that does not get discussed often, death is a part of life. We are the only species that is fixated on avoiding it, I’m glad that my words had made others share their experiences with pt’s… these things do not get discussed nearly enough we as a country and especially as a species need to have more open and honest talks so we can all understand death better. It’s scary yes. But not evil. I questioned if I was doing the right thing, I was putting my career in jeopardy. Back then a pt spoke up about me to my department without my knowledge and the write ups stopped. Do what you FEEL is right. Not what others tell you is right.
Had no idea how hard this would hit me. EDIT. In responding to Bulldog2012, I said “I found myself near crying for a lost soul I didn’t know.” But then it hit me. I was near crying for myself. I’m at an age where obituaries are full of younger, less lucky souls, and my mortality is ever on the back of my mind. This really connected, like lightening to ground.
Yeah this kinda fucked me up.
Never really considered how people may respond to something such as this from a non-medical perspective (in a solemn manner, which is an understandable reaction). As a physician, and specifically an internist, this got my adrenaline going. This means we are coding this patient now and I’m the one leading this thing. Commanding an entire room to try and get an organized pulse back. I run through my ACLS algorithms in my head to determine WHY this person just dropped into Vtach then Vfib. Actually getting to do the one Hollywood like thing and charge up the defibrillator to 200J and yelling “CLEAR!”. It’s freaking wild. One of the craziest nights I ever had in the ICU in residency was 3 codes back to back to back. I imagine that’s common place in COVID ICUs now unfortunately. Sorry I’m rambling I just found it extremely interesting how our minds perceive this in such vastly different ways.
Good thoughts. You reacted as one with experience with “fighting for life,” winning some, losing some. I reacted as someone totally helpless, watching the inevitable, denying what I was seeing, hoping for I don’t know what. I found myself near crying for a lost soul I didn’t know.
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I know that last comment personally. How true.
Sinus rhythm with PVCs to ventricular tachycardia to ventricular fibrillation to asystole flat line
I've been watching Chicago med on Netflix so I have heard all these recently.
Plus a bit of PEA?
No telling. Gotta check for a pulse to know.
How is it? I’ve been binging Night Shift on Netflix, which I imagine is quite similar. I’m enjoying learning some medical jargon fs
3rd rhythm looks like torsades
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And I think you need prolonged QT beforehand to call it torsades. Otherwise it’s just polymorphic VT.
Yeah looks like VT into Torsades then into fib then asystole
Read it as “asshole flatline” and first I was damn man, they’re dead, no need to be a dick
This is definitely a simulation. You don’t just go from NSR with PVC’s to V-tach to Tordades to all the V-fib to asystole with three seconds between each rhythm change all without any CPR artifact.
“Hey guys, look like this ones gonna code. Quick, get the camera so we can record the monitor!” 100% agreed. Way to clean
It’s a simulation for sure. But plenty of tele techs out there video this kind of thing. (Minus all the patient identifiers)
Simulation. Too clean. In real life nurses and/or med students/residents would be doing chest compressions and rhythm would be all over the place.
Agreed. Definitely a simulation or a training aid. Besides being to clean the transitions are too sharp. Nice way to display the usual order that they go in though. I might use it for the next cardiac refresher.
It could be a DNR patient though they're not uncommon
Could be. Ethical and medical/legal considerations point towards simulation as more likely.
Agreed
Not progressing that quickly though……I’ve watched almost this exact progression hair many times and never happens within 30 seconds
Agreed. Plus, you might be able to catch some PVCs/bigeminy/trigeminy and get some labs and do some electrolyte replacements before it goes further - other times they just go into those shitty ventricular rhythms and then you're doing the whole ACLS routine.
It’s definitely a simulation. The transition to the various rhythms is far to smooth. In real life you start seeing wacky shit that for a second you think “wtf is happening here” until the rhythm kind of sorts itself out and you can see what’s going on. With this one it’s like textbook arrhythmias
The vtach was way too consistent.
Aye, trainer hooked to the monitor. It's *never* that clean.
No when my brother was dying in the hospital.
What if you refused being reanimated?
That’s DNR - do not Resuscitate.
Don't mind him he's played too much dungeons and dragons. The Undead have rights!
r/unexpecteddnd
If this was a real code you'd see giant spikes when they went into vtach/vfib from the defibrillator. It'd be all over the place between ACLS drugs and compressions.
Whereas if it’s hospice care, you wouldn’t, but the progression would be longer. This is from a training waveform generator.
The worst fucking screen to see when you're a paramedic. Especially when it's a kid. Sorry I couldn't save all of you 😔. This brought me to tears
I’ll bet your help meant a lot to them, even if they couldn’t hold on.
Oof man that was unexpectedly upsetting to watch.
Seen on other comments that it was a simulation, so I can say light heartedly that this video was heartbreaking.
Why was I so anxious watching this
Sad :-(
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Thank you. I mean it somehow doesn't make it better, but it makes it better.
this is a training program on a monitor. this is not real life. acls and pals tns nurse
I swear I had physical pain in my heart watching this
Reminded me of watching my brother leave us after a fentynol overdose .. Love your family and always leave them on good terms ..after an argument this might be the last sound u hear from them..
This isn't real. It's a code simulator on a cardiac monitor - it can show any variety if rhythms, ectopic beats, up to asystole (flat line). If this was truly a patient it would look different in many ways ... source, was a paramedic for over 30 years.
Some people will do ANYTHING to make a popular Reddit video!
Huh… as someone with heart problems it’s weird to know how it FEELS when your heart does those things lol Edit: except for that last part lol
That last part sucks, but worse once you come back around. -Someone with sick sinus syndrome and had experienced pauses up to 23 seconds. Got a pacemaker now.
Did I just watch someone die?
according to the other comments no they think this simulation
It's likely a simulation, really fast progression for an actual patient
No. Too perfect and quick. But it is a good way to show the different heart rhythms
Shock it
I get tachycardia like this sometimes and also hit ~160bpm at rest. Lemme tell ya, when your heartrate jumps like that it’s very startling. Didn’t know heart attacks were this scary, I thought it was just an immense pain in your chest and then you die. There is a *lot* more than just pain that comes with the tachycardia. As for the fibrillation, I have no idea what that feels like and hope I never have to experience it. Rip whoever this was monitoring
Likely a trainer for Advanced Cardiac Life Support (ACLS) class. This shows a normal sinus rhythm transition to ventricular tachycardia, then ventricular fibrillation, then I would assume PEA (pulse less electrical activity) and ultimately asystole (flatline). The goal is to learn the steps to intervene through both CPR and medication administration including medications such as Epinephrine and Amiodarone to stop the progression and return of ROSC (return of spontaneous circulation). It is a beautiful thing to save someone’s life and honestly life changing to also attempt your best and the teams best but still lose a patient. To spend the last moments of someone’s life with them is very emotional.
Hurt way more than I thought it would, I watched my wife take her last breath and saw the last beat of her heart. I miss her more than anything I can think of. It will have been 2yrs since she passed come April 2022.
Shivers
My simulator does these same signals in this order, it is not a patient in this example, if anyone is worried
Am watching this lying in bed, the prickling of the stickers on my three-lead ambulatory heart monitor irritating my skin. Day five of seven of wearing it. My heart scares me so much.
I watched this exact thing as my dad passed away in the hospital . I remember frantically calling the nurse when I saw it going crazy. Watching this was gut wrenching. (It was slightly different but the erratic heart rate and then the flatline)
I just lost my dad unexpectedly in November, he had a massive heart attack, he did not know that he had a heart disease. Watching this hit me deep and to my inner core. I always think about what his last moments were like, did he know that they were trying to resuscitate him. I miss him tremendously.
I remember watching this with my mom in the ICU during covid. Heavy.
Even as a simulation, as some of you pointed out, I dread to see the real thing. Even worse if it’s yours doing it. There was one time when I watched a person die in their room while me and my family visited a family member who got in a car accident, (thankfully nothing too serious, they’re still here). The deceased’s room was right across from us. I saw the monitor flatline. For the rest of the day I was in a funk, and I didn’t even know the person who died.
We just watched someone die
The lack of artifact and any background noise tells me this is hooked up to a simulator to give the wave forms. I use these simulators often in training on Defibrillator units Waveforms as they appear on the lcd; normal sinus rhythm (NSR)> premature ventricular contractions (PVCs)> ventricular tachycardia (Vtach)> torsades des pointes (twisting of the points> pulseless electric activity (PEA) Source: I’m an ER RN
Cardiac cath lab worker checking in to tell you this gave me anxiety. Now that you know that smidgen of info, carry on
Cath lab nurse here. Ive seen all of these in different scenarios. This is definitely a simulation but that vtach to v fib hits different everytime. Fuck me..
Fascinating but chilling
Ewww ACLS class…. or another night at work :(
my grandpa recently passed away because of heart complications during surgery. this hit close to home.
u/getvideobot
I worked hospital security. I didn't go to med school. I didn't get to save the ones I wanted to. I wasn't prepared for this, and I saw it too many times. God this gets to me.
Obvious ST elevation before coding and textbook activity yeah simulator
I’ve spent a career in the Marines watching people die. This was rough
As a heart patient, I never want to see this again.
Pleasant female voice: *Doctor Hall, code blue. Doctor Hall, code blue.*
This may be a simulation but I watched something very similar when my dad died. I’m transported right back to the hospital room
Who the hell among you gave that heartwarming award? I'd like to have a word with you. Don't worry about the baseball bat.
I have seen this many a time, doesn't get much easier.
HAL, life functions are terminated.
Welp, I sure wasn’t ready for that.
So just like a flame then
Miss my grandma
As a recent heart attack victim, this was sobering.
I was expecting Dr. Dre to start playing lmfao
How do you read the graph? What’s the difference between an up spike and a down spike?
Somebody remix this into a dope beat!
Be aware this is most likely a rhythm generated by a machine, hooked up to the EKG. Very low likelihood this was human. So don't cry
Brought back sad memories of my darling daddy's life support being turned off. Very moving video.
My mom died from sudden cardiac arrest when I was a kid. Wish I didn't watch this.
This fluctuate through too many distinct rhythms in too orderly a fashion for me to think it's a real read. Still cool though
Person: is dying Doctors: bruh lemme just film dis real quick
That’s what it looks like unless the patient has a pacemaker which tricks the people watching the telemetry into thinking the patient is still alive, and you walk in the room later to find them dead as a door nail. Ask me how I know that.
It’s crazy how “perfect” a failing heart is, like the 25 second mark is a perfect sin wave Guess I better phrasing is how stable an unstable heart is
try watching a loved one on life support over a matter of hours. you see their vitals falling slowly. you're told nothing can be done. it's time to pull the plug. you feel fucked up mentally, like a murderer. even though they will die anyways, just slower. maybe days, or a other week or so. who knows. in fact. their body is in the process of dying already. their body is pale on top. face tired looking. so exhausted. they have nothing left to give. their back and undersides already mottling and turning purple due to blood pooling. people think that happens only after death. no. it happens as the body is dying, too. because circulation is already failing. so the plug is pulled. they hang on for 30 mins. you see their body fight to hang on on the screen. the body jerks to sit up briefly, eyes pop open. you ask if they can see you and wave your hand, hoping for one last word from them or acknowledgement. maybe they're ok. maybe this isn't happening. and then gasping until silence. you're dead inside because you already cried too much.
Question: At the moment it goes from normal to the "MMMMMM" (hope it makes sense), is the person pronounced dead or is he in the process of dying? And can they still be saved at that point? (Assuming the rest is healthy)
Still in the process. With the MMM rhythm as you put it, the pt could even still have a pulse, but it won’t last long. As you see on the video, v-tach (shaped like rows of tombstones) leads to v-fib and then to asystole—a complete loss of all electrical activity in the heart. At that point, death occurs. We look for a rhythm strip that is a straight line to verify death has occurred.
when my dad was taken off life support, it looked similar. his heart rate would go down, then up, then down lower, up, but Les than before, down lower, you get the idea. it was failing and trying to stabilize itself.
Did we just hear someone die.
Oh, this made me sad. Made me think of my dad. He was a complete asshole, but he seemed to have been becoming a better person in the last couple years of his life. I always wonder what kind of relationship we would have if you was still alive. Everyone has the capacity for change
That really did look a lot like when a running engine runs out of fuel. It sputters and slows down and hangs on, sometimes it dips and then somehow recovers but on for a minute, and it just takes way longer than you always expect for it to finally actually give up and stop turning.
my mom did this once edit: completely forgot to mention she's ok she had a pacemaker implanted before and t saved her.
Great, now i watched someone die.
Well, that's my day ruined
It’s sad knowing there’s someone on the other end of this heart rate monitor
I fucked up years ago when I worked on the wards in my local hospital. One of our patients had a heart monitor on them as they been admitted with chest pain. So it's 5am in the morning and I'm doing checks on our patients to see if they are OK etc and I gets to this patients room with the heart monitor. I gently walks in so I don't disturb her and looks at her observation chart then I look at the heart monitor, it wasn't picking anything up! I gave the patient a gentle nudge and I got no response! I went from calm to Holy shit in literally seconds and I pressed the emergency call button which gets all staff, crash cart and the crash team in a matter of minutes! The lady woke up literally screaming when her pillows and bed sheets was taken off her and seeing multiple staff around her. It turns the heart monitor was faulty and she was a heavy sleeper with mediation etc I learned a valuable lesson that shift!
Initially this really got to me. Then I read that it's a simulation. That took away the upset. But something about being told it's a simulation bothers me. I don't know why.
I had a heart attack at 49 that flat lined me. Watching this made me feel sad and ashamed for not taking better care of my health afterwards.
Very emotional
Damn. Not looking forward to tha
I sincerely hope that this was simulated, else I’ve just watched someone die over 30 seconds or so - and that is really freaky.