Several years ago, I was given a small statuette of a fireman by the ICU nurses. Everybody thought it was funny since just a few days earlier I had put out a small fire in ICU.

The patient in his forties was admitted with a subarachnoid hemorrhage due to a ruptured cerebral aneurysm. Suddenly, he went into a cardiac arrest. His monitor showed ventricular tachycardia. An immediate defibrillation was indicated. The crash cart was brought in and the defibrillator patches were applied (see chest XR above with arrows pointing to the defibrillator patches). In the excitement of the moment, nobody paid attention to the excessive hair growth on his chest.

The defibrillator was charged, the shock was delivered and…the defibrillator patch caught on fire. The hair on his chest started burning as well. The smell of burning hair was nauseating. I was standing right next to the patient and was able to put the fire out by forcefully blowing on it, the same way you blow on a cake candle. In the hindsight, I realize that BLOWING AIR ON THE FIRE WAS THE DUMBEST THING TO DO. Luckily, the patient was not on any oxygen. The smart thing to do was to throw a blanket on it. One more thing…watch where you put those patches on the patient. Chances are, you are not going to have enough time to shave the chest.

The patient required a single shock to convert back to a normal rhythm. His aneurysm was subsequently coiled to prevent further bleeding. He was discharged several weeks later with some residual neurological deficits.