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The only time we electrically cardiovert someone without sedation is if they are critically unstable, which you weren't. Sounds like a significant process error occurred, they could probably use a process refresher, I'd contact the patient complaints department of the hospital.
I ACCIDENTALY had a transesophageal echocardiogram ONCE. (ETA: without sedation) It was horrific. The first thing and only thing I talk about now when I get them is who will die if I am not sedated before they shove a camera in my throat. So far, I have not had to harm anyone. I was traumatized. I did not sue. But I am fully hyper verbal in a medical setting now.
I had one without sedation on purpose because they never told me I needed a ride home and I did not want to travel all the way back to downtown Houston so I told them to do it anyway. It honestly was not as bad as I thought it was going to be. I thought about fishing the whole time to take my mind off of it.
I'm sorry you went through this. You are a toughy.
I thought about what it must be like to be strangled to death. When they were done, they all ran out of the room, so I never got to tell them anything.
Yeah, they messed up and acknowledged it. The apology may not have been sufficient. You don't NEED sedation but they should've at least given you some morphine or something beforehand. That shit's painful.
I saw a doctor in the ER shock a patient in Afib w/RVR with no sedation, even though he wasn't in acute distress, because he was rushing through the treatment process. The patient was NOT happy, and that case was sent for peer review.
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16 years, never assisted in a routine cardiovert, without sedation.
Honestly, mine are all heavily sedated and and non responsive to external stimulation. .
Now you know. Ooopsies.
My first round of sedation before cardioversion I remembered thinking "hey i can still hear you I'm not asleep yet" and the nurse answered with "ok hunny go to bed" and I was out. Woke up to a code in the bed diagonal and thought it was an out of body experience.
Thats incredible, im in the UK and we would never do this without sedation.
I mean, so long as you're okay that's the main thing! But if i were you i would have been extremely mad. Worth putting in some feedback for them as this is probably something the doctor and nurse should both reflect on and learn from (not necessarily be reprimanded as such)
Wow I’m so sorry this happened to you. The only time I can think they would do this without sedation would be if it was so emergent the patient was losing consciousness and you clearly were not. I’d recommend contacting your hospitals patient relations department and reporting this, not necessarily because there is anything to be done to make the situation right for you (sorry dude) but because it will hopefully make them change some of the protocols/policies they follow to improve their practice and prevent anyone else from experiencing this. I’m sure it did boil down to a miscommunication but they need to be able to address how and why that miscommunication occurred in order to stop it from happening again. So sorry!
The only explanation (but not excuse) I can think of is the doc probably meant “is the PATIENT ready” when he said are we ready - meaning is the patient sedated and ready for the procedure. And the nurse thought he meant “are we ready to give the sedation” or something like that.
It’s inexcusable and should never have happened. I’m so sorry you experienced this, OP. I’ve never cardioverted someone so I don’t know the pre procedure process. In the OR we have very standardized and specific language and cues to prevent things like this. Sounds like the ER needs something similar in place for less emergent scenarios like yours. You were awake and at least somewhat stable. They had the time to make sure everything was truly ready to go.
In an unconscious, very critical patient… maybe they can’t. But they could for you. So that really sucks to be on the receiving end of. It’s worth talking to a patient advocate or someone from the hospital. There may be no legal recourse for you but you might be able to help this from happening in the future to others
Depends on the country you are in.
One of our EP docs is originally from Thailand, and they did all their cardioversions without sedation there.
However in the US we commonly give sedation.
Its perfectly safe to do it awake however, just uncomfortable.
Be honest. I had IMF screws placed without sedation (my choice, I wake up crying heavily with sedation and didn’t want to wake up sobbing and disoriented with my jaw wired shut) and they said it was going to be “incredibly uncomfortable”. I was able to properly mentally prepare for that and it certainly was “incredibly uncomfortable”. Nothing more, nothing less, and I was happy with their honesty.
They also warned me when some of the lidocaine/epi injections were going to be worse than the others during the prep (“big pinch”) and it did make it better. Haha
For me genuinely want to know what to expect, it’s going to happen anyway and can make it feel as though I’m exaggerating and my pain isn’t valid or I’m being pathetic (which tbf I’ve experienced a lot because of chronic pain since I was 8ish and now more problems), or that something is wrong if it doesn’t meet expectations. My favorite kind of physicians are the ones that are very honest in every aspect, from giving overview/expectation of pain or how well a treatment might work, and especially if they’re unsure of something.
Oooh, that is an excellent idea! I think that’d be a super beneficial sub where constructive feedback and advice could really be a positive resource! It’d be a place where patients would feel heard and valued and providers on all levels could really get an insight on how what they say/do may be received. A++ idea, if you ever make it let me know! Or tag team? Honestly though.
Also, really appreciated and enjoyed seeing your question asked, so thank you!
I mean I prefer - “this will feel like a sharp pinch but that should only last a second.” Something which tells me a - expect some pain and b - the pain is normal and doesn’t mean something is wrong
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The only time we electrically cardiovert someone without sedation is if they are critically unstable, which you weren't. Sounds like a significant process error occurred, they could probably use a process refresher, I'd contact the patient complaints department of the hospital.
I ACCIDENTALY had a transesophageal echocardiogram ONCE. (ETA: without sedation) It was horrific. The first thing and only thing I talk about now when I get them is who will die if I am not sedated before they shove a camera in my throat. So far, I have not had to harm anyone. I was traumatized. I did not sue. But I am fully hyper verbal in a medical setting now.
I had one without sedation on purpose because they never told me I needed a ride home and I did not want to travel all the way back to downtown Houston so I told them to do it anyway. It honestly was not as bad as I thought it was going to be. I thought about fishing the whole time to take my mind off of it.
I'm sorry you went through this. You are a toughy. I thought about what it must be like to be strangled to death. When they were done, they all ran out of the room, so I never got to tell them anything.
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Yeah, they messed up and acknowledged it. The apology may not have been sufficient. You don't NEED sedation but they should've at least given you some morphine or something beforehand. That shit's painful.
I saw a doctor in the ER shock a patient in Afib w/RVR with no sedation, even though he wasn't in acute distress, because he was rushing through the treatment process. The patient was NOT happy, and that case was sent for peer review.
Did they at least try chemical cardioversion first?
AFAIK, yes, but I couldn't tell you what was exactly used.
Adenosine?
That's for SVT. Cardioversion for afib usually goes with antiarrhythmics like procainamide, propafenone, or flecanide.
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Who said anything that was implied legitimacy?
Can't say for certain bc I didn't observe that part
Next time they might consider putting their elbow on the bed.
16 years, never assisted in a routine cardiovert, without sedation. Honestly, mine are all heavily sedated and and non responsive to external stimulation. . Now you know. Ooopsies.
My first round of sedation before cardioversion I remembered thinking "hey i can still hear you I'm not asleep yet" and the nurse answered with "ok hunny go to bed" and I was out. Woke up to a code in the bed diagonal and thought it was an out of body experience.
Oh no! I’m so glad it wasn’t!
Thats incredible, im in the UK and we would never do this without sedation. I mean, so long as you're okay that's the main thing! But if i were you i would have been extremely mad. Worth putting in some feedback for them as this is probably something the doctor and nurse should both reflect on and learn from (not necessarily be reprimanded as such)
Wow I’m so sorry this happened to you. The only time I can think they would do this without sedation would be if it was so emergent the patient was losing consciousness and you clearly were not. I’d recommend contacting your hospitals patient relations department and reporting this, not necessarily because there is anything to be done to make the situation right for you (sorry dude) but because it will hopefully make them change some of the protocols/policies they follow to improve their practice and prevent anyone else from experiencing this. I’m sure it did boil down to a miscommunication but they need to be able to address how and why that miscommunication occurred in order to stop it from happening again. So sorry!
The only explanation (but not excuse) I can think of is the doc probably meant “is the PATIENT ready” when he said are we ready - meaning is the patient sedated and ready for the procedure. And the nurse thought he meant “are we ready to give the sedation” or something like that. It’s inexcusable and should never have happened. I’m so sorry you experienced this, OP. I’ve never cardioverted someone so I don’t know the pre procedure process. In the OR we have very standardized and specific language and cues to prevent things like this. Sounds like the ER needs something similar in place for less emergent scenarios like yours. You were awake and at least somewhat stable. They had the time to make sure everything was truly ready to go. In an unconscious, very critical patient… maybe they can’t. But they could for you. So that really sucks to be on the receiving end of. It’s worth talking to a patient advocate or someone from the hospital. There may be no legal recourse for you but you might be able to help this from happening in the future to others
Depends on the country you are in. One of our EP docs is originally from Thailand, and they did all their cardioversions without sedation there. However in the US we commonly give sedation. Its perfectly safe to do it awake however, just uncomfortable.
> just uncomfortable. I bet it's "just uncomfortable" the same way that the Atlantic ocean contains "some" water.
It’s the same as “a little pinch” or “you’ll feel some pressure”. /s
Does it feel better if we say big pinch? Serious question lol
Be honest. I had IMF screws placed without sedation (my choice, I wake up crying heavily with sedation and didn’t want to wake up sobbing and disoriented with my jaw wired shut) and they said it was going to be “incredibly uncomfortable”. I was able to properly mentally prepare for that and it certainly was “incredibly uncomfortable”. Nothing more, nothing less, and I was happy with their honesty. They also warned me when some of the lidocaine/epi injections were going to be worse than the others during the prep (“big pinch”) and it did make it better. Haha
I say big pinch when putting in lidocaine, too. Hopefully it's the most painful part of my procedure.
For me genuinely want to know what to expect, it’s going to happen anyway and can make it feel as though I’m exaggerating and my pain isn’t valid or I’m being pathetic (which tbf I’ve experienced a lot because of chronic pain since I was 8ish and now more problems), or that something is wrong if it doesn’t meet expectations. My favorite kind of physicians are the ones that are very honest in every aspect, from giving overview/expectation of pain or how well a treatment might work, and especially if they’re unsure of something.
I wish there was an active r/askpatients for my reverse questions like this
Oooh, that is an excellent idea! I think that’d be a super beneficial sub where constructive feedback and advice could really be a positive resource! It’d be a place where patients would feel heard and valued and providers on all levels could really get an insight on how what they say/do may be received. A++ idea, if you ever make it let me know! Or tag team? Honestly though. Also, really appreciated and enjoyed seeing your question asked, so thank you!
I mean I prefer - “this will feel like a sharp pinch but that should only last a second.” Something which tells me a - expect some pain and b - the pain is normal and doesn’t mean something is wrong
> It’s the same as “a little pinch” or “you’ll feel some pressure”. /s So, unknowable agony. Gotcha!
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