Can You Be Shocked by Touching Someone With an Internal Defibrillator?

If you find yourself in a situation where a person with an internal defibrillator (ICD) has just received a shock, it is essential to understand whether you or anyone else could also experience a shock through physical contact. Let's delve into the specifics of how these devices function to clarify any concerns.

How Internal Defibrillators Work

Internal defibrillators, such as implantable cardioverter-defibrillators (ICDs), are medical devices designed to deliver a controlled electrical shock to the heart to restore a normal heartbeat. These shocks are contained within the body and are not transmitted to the surrounding environment. In other words, touching someone who receives a shock from an ICD will not result in you being shocked.

Ensuring Safety

As a general rule, it is crucial to follow the advice of medical professionals when dealing with individuals who have medical devices like ICDs. If someone is receiving medical attention, it's advisable to adhere to their instructions to ensure safety and effectiveness of the treatment. However, knowing the science behind these devices can help alleviate any concerns.

Conductive Path and Touching the Patient

While the device itself keeps the shock contained within the patient's body, touching the patient's skin can potentially alter the conductive path through which the electrical jolt travels. Specifically, if you touch the area of the body where the defibrillator is delivering the shock, it could negate the intended effects. Therefore, it is important to avoid direct contact with the specific area being treated.

External Defibrillators vs. Internal Defibrillators

It's worth noting the difference between external and internal defibrillators. External defibrillators, such as Automated External Defibrillators (AEDs), can deliver energy discharges up to 360 joules. In contrast, internal defibrillators typically use up to 50 joules, and automatic implantable defibrillators use up to about 30 joules. This lower energy level significantly reduces the chances of any shock being transmitted to you or others.

Clinical Examples and Practical Advice

Several studies continue to explore the optimal way to perform chest compressions while an AED or a manual defibrillator is in use. In clinical scenarios, it is not uncommon to see situations where an ICD fires during intimate activities, leading to cardiac arrhythmias. In such cases, the individual with the ICD may experience severe pain, while the partner might report a mild tingling sensation.

When medical personnel use external defibrillators, they often deliver doses of up to 120 to 200 joules, which can cause significant sensation in the person being shocked. In contrast, internal defibrillators use far less energy, with some studies suggesting as low as 2.64 joules for internal pacing. Newer models of ICDs are designed to use even less energy. In my experience, performing CPR on a person with a firing ICD did not result in any sensation, likely due to wearing gloves or the presence of sweat that facilitates conduction.

Conclusion

In summary, you would not be shocked if you were touching someone who received a shock from an internal defibrillator, as long as your hands do not bridge the path between the pads. However, it is essential to use caution and follow the guidance of healthcare professionals. Understanding the mechanisms behind these medical devices can help in assessing and managing risks effectively.