Brain Death (or Shirt’s on Fire!)

I was trolling CNN the other day and ran into the following news title. “Defibrillator sets patient’s clothes on fire.”

That totally sounded like one of those urban myths, like how Pop Rocks and Coke will make your stomach explode (no, but it will give you fantastic burping capabilities). Since one of my past times is telling friends and family that their silly for believing everything that they read, this short news blurb caught my attention and I had to read it. CNN’s news bit was short and to the point. A 47 year-old Connecticut woman was zapped, her clothes caught on fire, but no one was hurt.

Mary Newman, of the National Center for Early Defibrillation in Pittsburgh, said “When you defibrillate a person, they are already dead.”

Point taken, Mary, but that still begs the question, how did it happen, and is this dangerous? I have to point out that I totally agree with the sentiment here. If you’re getting shocked, it’s because your heart is stopped. If your heart stops beating, you’re dead. A hundred years ago, that was the end of the story. No pulse, no life. These days, we have this interesting term ‘brain dead.’ Most people I’ve talked to think that brain dead means that not only has your heart stopped, but your brain is no longer shooting neurons all over the place.

Actually, you can be brain dead even though your heart and lungs are still working. Brain death is like tuning to a channel that’s off the air … I just realized that those of you who have known only the land of cable have no idea what this example means. In the old days (1980 and earlier), TV stations used to run out of things to air, and you’d tune in to a test pattern or static at 3 in the morning. I can remember waking up early and watching a test pattern for almost an hour before Pinwheel came on. Perhaps a better example might be ‘the lights are on, but no one’s home.’

So what is brain death? Harvard Medical School officials conceived the term “brain dead” in a 1968 paper. Officials there hoped to resolve a novel phenomenon: With new technology patients who were dead could still have a heartbeat — and give the false impression that they were very much alive while kept on a ventilator. All US states have since recognized that doctors can use brain death as the sole criterion for determining that a patient has died. Doctors must perform various tests to verify brain death, and if the tests show brain activity, the patient may be in a coma or vegetative state. A brain dead person doesn’t show brain activity.

Good to get that cleared up. If your heart stops, your dead. If your brain stops, you’re dead. While you can have a heart beat without a brain, you can’t have a brain without a heart. Gee, guess which one’s more important?

Back to the fried dead chick. A defibrillator is a device that administers a controlled electric shock, either to the exterior of the chest wall or directly to the exposed heart muscle, to restart or to stabilize heart rhythms. A nurse friend of mine joked that it was like sticking your finger in a socket. If you accidentally get shocked and you’re alive, generally you’ll be alright, but if you happen to have an off kilter heart rhythm or unknown heart conditions, it can adversely affect your health. Getting shocked isn’t all good, as you can guess from how many people die from sticking their fingers in sockets or getting hit by lightning. The defibrillator has these paddles that you slap onto someone’s skin (you can do it through clothes, but the material might interfere) and thusly shock them.

Anyone who’s seen lightning strikes knows that there’s an arc of electricity from cloud to ground. If you have a cat and it’s winter, you can see static electricity sparks at night if the cat’s snuggling up on your fuzzy blanket. That may just be me and the Vermicious Knid, though. The reason you can see the arc is that electricity likes to make the shortest jump possible. It’s lazy. It wants to go from point A to point B in the fastest time allowed. Which means that, in theory, if the paddles aren’t right against the skin, there could be an arc that might light clothes on fire.

Our end result is that the local fire marshal for our poor woman said that paramedics told investigators that an electrical arc jumped from the defibrillator pads to a fiberglass and metal stretcher in the ambulance before it ignited the woman’s clothes. No details about the condition of the dead woman’s body or damage to the ambulance.

You’d think there would be a lot of records of this happening, but it’s freakishly rare. US Vice President Dick Cheney has a small defibrillator implanted to monitor and electronically slow abnormal heart rhythms. It’s called an Implanted Cardiac Defibrillator (ICD) and they’re pretty common enough these days. My grandfather probably could have used one. A look on Snopes (my favorite myth busting site) shows nothing of value.

Personally I think that they’re a little off the mark on this one. There’s got to be more to it, or at least some science. I’ve submitted the idea to Mythbusters in the hopes they’ll put it to the show.

Hey, maybe they’ll offer me a job!

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