Cardiopulmonary Thump

[jroyster06]

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?

 

[Shishkabob]

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]

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

 

[Shishkabob]

No no, the pt went in to witnessed VT, thumped, shocked, and went back in SVT, which he was before VT.

 

[adamjh3]

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.

 

[jroyster06]

adamjh3,

That would be awesome thanks bud!

 

[jjesusfreak01]

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]

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]

 

[jroyster06]

BAHAHAHAHAHAHH my connection is to slow to veiw the video but i get it lol

 

[piranah]

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"...