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In movies or television, the doctor gets giant heavy clothing iron sized leads. Clashes them together and uses them on the patient that has a flat lined heart and after doing it 1 times per second the patient wakes up.
Is it just another dramatic effect? Do doctors/EMT really do this?
While it used to be done, in reality anymore it isn't done as it is possible to damage the equipment by rubbing, and the possibility exists of an accidental discharge between paddles which can be dangerous for everyone around.
In older times, conductive gel was applied directly to the paddles, and doctors/EMT's would rub the paddles together to distribute the gel evenly on the paddles. Now, there are conductive pads that are placed on the patients skin, and the paddles are used against those.
Additionally, when you see a flatline on the heart monitor, either the leads have become detached or the patient is in a condition called asystole. Asystole is an absence of any electrical activity in the heart, which means that the defibrillator (Note the name) will not work. When the heart is in a wild jagged line, it is "fibrillating", and the paddles work to disrupt that fatal rhythm and restore a normal sinus rhythm.
This is additional information for John's otherwise good answer.
Although they're rarely used, it's still common to see paddles on the defibrillators used in EMS at the paramedic level. See those packs on the side of the unit in the photo below? In addition to cables, ECG pads, and defibrillator pads, there are paddles in there along with a tube of conductive gel. I can't ever recall seeing a 12-lead on a paramedic unit that didn't have paddles.
They're there because EMS doesn't have the luxury of a supply room down the hall. They typically carry extras of all the disposable items, but it's always possible to run out of something because of back-to-back calls, multiple patients, etc. It would be very difficult to explain to your medical director that your patient arrived dead because you ran out of defib pads, and even harder to explain to the family. There can also be situations where pads just can't be used. For example, severe burns to the chest. Pads would tear skin off when they're removed.
There's even a scene showing them being used in this product video (loud volume).
What's not true is the clashing them together part. They're just rubbed against each other to smear the gel evenly on both paddles. There's no clashing.
