A patient on an table flails around a bit and the heart monitor they're connected to goes flat and emits a long single tone

"He's flatlining!" screams a doctor

In the background you hear a high-pitched, increasing whine as someone charges up a defibrillator. Someone yells something in medi-speak. Someone sticks defib pads on the patient's chest.


The patient jolts violently on the table as electricity pulses through their body

"Again! Clear!"

The patient jolts violently and suddenly -

Beeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeep--beep--beep--beep goes the EKG.
"He's got a pulse, we save-"

"NO! No, no no no!" I scream, smashing the paddles out of a nurse's hands and kicking over the defib unit. "No no no he's DEAD you fucking idiots."


Someone really needs to get the news out to writers because oh-my-god this is so widespread that I was starting to think I was crazy. Defibrillators stop irregular heart contractions. If your heart muscles get all fucked up you shock 'em straight again. If you have no heart contraction (i.e. no pulse) you cannot defibrillate to fix it. It's right there in the goddamn name: de-fibrillation. When your heart is fibrillating (a bad thing) you de-fibrillate it to save your life. If you're flatlining, the only thing that will save you is your body going "Oh shit better restart that" or a big 'ol shot of adrenaline. Shocking a dead heart will not fix it.

Shocking a dead heart will not fix it
Shocking a dead heart will not fix it
Shocking a dead heart will not fix it
Shocking a dead heart will NOT fix it

Defibrillators serve an important purpose. They are a very important tool and most commonly come into play after someone has a heart attack. They are used in some cases of cardiac arrest, but that's because cardiac arrest means more than just "no heartbeat". It can mean "different parts of the heart are contracting out of sync so it's not pumping blood properly". It can also mean "heart beating ridiculously fast, interrupting normal function". Think of it like this: the arrest in cardiac arrest doesn't mean "has stopped", it means "has stopped normal function" Two of the four types of cardiac arrest can be treated with defibrillation. The other two - "flatlining" being one of them - cannot.

In the case of no heart contraction at all, all you can do is CPR to prevent brain and tissue damage (CPR manually circulates oxygen, hopefully preserving the brain and other tissue long enough to get other equipment in place). Epinephrine/adrenaline is used to restart the heart, if it is available. (Usually a dose is given every three minutes for the duration of the cardiac arrest) For the most part, though, you just hope that the heart will restart on its own. The resuscitation rates for cardiac arrest are depressingly low.

Every time I watch a movie or a TV show and someone flatlines I get excited and then, inevitably, severely disappointed. I have yet to see them get it right, with one near-exception. The first flatlining event in SG1 had me so excited: the doctor in the foreground whipped out a big-ass needle and I nearly screamed "OMG is that adrenaline!?" I didn't hear/see the defib charging up until a nurse shouted "clear!" and then it was too late and I nearly cried. They were so close. So damn close and then they fucked it up. The SG1 writers are usually so good about that kind of shit (for the most part, their techno-babble and theoretical physics are sound), I am actually bitter that they continue to get the defib thing wrong. I had such high expectations of you, SG1. You're better than that.

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