Asystole, (Flatliner) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

This book describes Asystole (Flatliner), Diagnosis and Treatment and Related Diseases
Asystole
Flatliners is a movie where 5 medical students stop their heart beat by using electric shock to their heart for longer and longer periods of time before being resuscitated back by their friends.
I saw the 1990 version of this movie. It was particularly interesting for me as a medical doctor. Apparently there is 2017 version of this movie.
A cardiac flatline is the state of total cessation of electrical activity from the heart, which means no tissue contraction from the heart muscle and therefore no blood flow to the rest of the body.
While the heart is asystolic, there is no blood flow to the brain unless CPR or internal cardiac massage (when the chest is opened and the heart is manually compressed) is performed, and even then it is a small amount.
After many emergency treatments have been applied but the heart is still unresponsive, it is time to consider pronouncing the patient dead.
Even in the rare case that a rhythm reappears, if asystole has persisted for fifteen minutes or more, the brain will have been deprived of oxygen long enough to cause brain death.
Cardiac arrest (unlike asystole) is brought on by irregular beating of the heart that causes it to stop supplying blood flow to the other organs, including the brain.
In cardiac arrest the heart is still beating irregularly (the ECG shows abnormal rhythm) while in asystole the heart is completely not beating (ECG is a flatline)
Asystole is completely different from cardiac arrest.
Asystole is a critical type of cardiac arrest in which the heart stops beating and there is no electrical activity in the heart.
As a result, the heart is at a total stop.
When a person goes into asystole, the person must be rapidly revived using CPR.
Asystole is treated by cardiopulmonary resuscitation (CPR) combined with an intravenous vasopressor medicine such as epinephrine (adrenaline)
Many other methods may be done such as defibrillation or medicines can also be given such as atropine, epinephrine, vasopressin, internal cardiac massage (the person is opened up and pressure is applied directly to the heart).
1. Primary asystole forms when cellular metabolic functions are no longer whole and an electrical impulse cannot be produced.
With serious ischemia, pacemaker cells cannot transport the ions needed to affect the trans-membrane action potential.
Implantable pacemaker malfunction may also be a cause of primary asystole.
Proximal occlusion of the right coronary artery can produce ischemia of both the sinoatrial (SA) and the atrioventricular (AV) nodes.
Secondary asystole
Frequent causes are:
1.Suffocation,
2.Near drowning,
3.Stroke,
4.Massive pulmonary embolus,
5.Hyper-kalemia,
6.Hypothermia,
Symptoms:
A rhythm that is truly asystole and has been present for more than several seconds will cause the patient to be unconscious and not responsive.
A few agonal (final gasping) breaths may be observed
The detectable heart sounds and palpable peripheral pulses are absent.
Diagnosis
Asystole is normally a diagnosis made through continuing cardiac monitoring or electrocardiogram (ECG) and physical examination with pulse-less-ness.
Treatment
Electrical defibrillation is never the first choice of treatment in the patient in asystole
The treatments in the emergency department are:
1.Providing oxygenation and ventilation through endotracheal intubation and
2.Improving circulation through cardiopulmonary resuscitation (CPR),
3.Attempting transcutaneous or transvenous pacing
4.Administrating of pharmacologic agents.
The only 2 drugs advised are epinephrine and vasopressin
Vasopressin gives a better prognosis than epinephrine although it is poor in both cases.
TABLE OF CONTENT
Introduction
Chapter1 Asystole
Chapter2 Causes

• Language: English
• Publisher: Kenneth Kee
• Release date: Apr 7, 2018
• ISBN: 9781370191857

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Asystole,

(Flatliner)

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2018 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Asystole (Flatliner), Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What The patient Need to Treat Asystole)

This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Asystole

Flatliners is a movie where 5 medical students stop their heart beat by using electric shock to their heart for longer and longer periods of time before being resuscitated back by their friends.

I saw the 1990 version of this movie. It was particularly interesting for me as a medical doctor. Apparently there is 2017 version of this movie.

A cardiac flatline is the state of total cessation of electrical activity from the heart, which means no tissue contraction from the heart muscle and therefore no blood flow to the rest of the body.

While the heart is asystolic, there is no blood flow to the brain unless CPR or internal cardiac massage (when the chest is opened and the heart is manually compressed) is performed, and even then it is