Cardiopulmonary Thump

jroyster06

Forum Crew Member
59
1
0
Well accodring to my Medic class i just got done with cardio thumps arent taught any more. Now i have never had an opportunity to try it, do they really work? I was talking to a nurse in the cath lab the other day on my medic rotations that said after she gave lidocane to a pt that had an allergy to it the pt went into asystole. She said she got her back with a quick thump. Thinking about it i have no problems at all trying it because it takes half a second to do. Its more out of curiosity. How hard do you gott wack em if it does work?
 

Linuss

Forum Chief
8,264
32
48
You mean a precordial thump?


Saw it used once in a code a few weeks back by a doctor... didn't work. Shocked and went back in to SVT.
 

jroyster06

Forum Crew Member
59
1
0
I wouldnt think about using it in SVT but i guess it wouldnt hurt. Cardioverted and pt remained in SVT? even with subsequent(sp?) shocks? Yea pericardial thump sorry its been a very very long day
 

Linuss

Forum Chief
8,264
32
48
No no, the pt went in to witnessed VT, thumped, shocked, and went back in SVT, which he was before VT.
 

adamjh3

Forum Culinary Powerhouse
1,873
6
0
The way I understand it is it's really only effective if used at the onset of V-fib or pulseless V-tach. If done at exactly the wrong time by someone who saw it in a movie and is trying to help, I imagine it could cause Commotio Cordis, however, this I'm unsure of.

I also recall reading somewhere that 20% (give or take 5) of people who recieve a precoridal thump get ROSC. I'd link to a source, but I'm on my phone at work, I'll see if I can't expand on this when/if I get back to station.
 

jjesusfreak01

Forum Deputy Chief
1,344
2
36
I think the problem is that its best indication is when someone is going into witnessed Vtach/Vfib. Witnessed means you have to have a monitor attached to be sure, and having a monitor attached means you are probably just going to shock them out of it. Therefore, there's nothing wrong with a precordial thump, you just aren't going to have a legitimate opportunity to do it very often.
 

AtlantaEMT

Forum Crew Member
89
0
0
I got to see one a few weeks back on my first code. Guy went into V-tac at 212bpm and the doc did one (before that I never even heard of precordial thump) and it went down to 162 instantly.

Sometimes I think that is a technique we should be allowed to use on conscious pantients. But here is living proof it works...
[YOUTUBE]http://www.youtube.com/watch?v=xdMYHsfyLX8[/YOUTUBE]
 

piranah

Forum Captain
403
6
0
I work with a crew that got a refusal on a cardiac arrest..(i saw the written report and strips)...found 80something year old guy supine breathing unconscous put on monitor viewed SR downgraded to v-fib..very old experienced tech did precordial thump..converted to SR guy woke up A+Ox4 signed refusal stating "i wanna die at home"...
 
Top