DESCRIPTION

You will see no rhythm at all – just a flat line. Actually, real asystole is almost never a perfect flat line: there is usually some baseline wander from breathing or chest compressions. On the above figure it certainly looks like nothing is happening between the two beats!

HABITAT

This rhythm may be found anywhere, but is either ephemeral or permanent. In other words, you are not likely to find anyone walking around with asystole.

CALL

“I think a lead is off … oh no, he’s not breathing!”

RESEMBLANCE TO OTHER ARRHYTHMIAS

It could look like what happens when a lead falls off or the monitor is switched to the “calibrate” mode. Always remember to check the patient! Real asystole usually shows some baseline artifact, either breathing or some signs of movement, even if it’s from someone shaking the patient or doing CPR. A lead off or an electrical fault will often look absolutely straight line – as it does in the movies. Compare our two examples. Can you tell the difference?

Fake asystole: a lead is off or something

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