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"Clear!"
— Every defibrillation scene ever

Hank: In case I'm incapacitated for any reason, do you know how to revive a man's heart with a downed power line?
Bobby: No.
Hank: Well, there's really no wrong way to do it.
King of the Hill

Apparently, the defibrillators they buy for fiction can revive anyone because Lightning Can Do Anything. Like CPR, the paddles can bring back a patient from the brink of death in all but the most dramatic situations. The patient will always jerk violently when the charge is applied, and if the portrayal is inaccurate enough, you'll see visible sparks. Especially common after a Hollywood Heart Attack.

In real life, the defibrillator is a highly useful and remarkable device, but it isn't a magical "revive instantly" machine. Automated External Defibrillators are increasingly being installed in public places. But these devices can only reset a heart's rhythm, not restart a still heart. It's like trying to fix a computer with a bad power supply by pressing the reset button. CPR is used for several minutes before attempting so. Also, gel has to be applied, to prevent burning the person's chest. This is conveniently forgotten every time... the image of someone being shocked back to life is quite striking though.

Flatlining is not shockable, it will do absolutely nothing. It is never done by people who know what they are doing. There are only two shockable rhythms, ventricular tachycardia and ventricular fibrillation (hence the name "defibrillator").

Paddles are very rarely used these days. In most hospitals flexible, sticky pads are used instead; they are safer and easier.

The pads are put on the right side of the chest and left side of the ribcage. After measuring the heart rhythm, a shock is applied to the heart. You're not supposed to touch the paddles after putting them on; it could screw up the reading when it's measuring or disturb the current harming both you and the patient. That is why the standard command before firing is "Clear!" to make everyone except for the operator get out of physical contact with the machine and patient.

A logical extension to this is to eschew the medical machine and just hook the poor guy up to a suicide cord (that's a technician's term for a wall plug with nothing but two bare wires). Ironically, shocks from mains power like this are usually a good way to induce the conditions that need defibrillation, and therefore a horrible idea. This may lead to the occasional subversion in thrillers and action flicks where defibrillator paddles are used offensively. Whether this is used accurately or not in medical dramas will be a toss-up (House and Greys Anatomy both tend to shock flatlines. ER didn't most of the time.); expect it to be used humorously everywhere else.

This trope also covers literal magical defibrillators in the form of applying lightning-based powers to revive people, though depending on exactly how magical and handwavy those powers are, this may be somewhat more justified.

On a side note, the correct treatment for cardiac arrest is an injection of adrenaline into the heart muscle.


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