Precordial thump
Precordial thump | |
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Specialty | cardiology |
Precordial thump is a
Procedure
In a precordial thump, a provider strikes at the middle of a person's
Effectiveness
Precordial thump may be effective only if used within seconds near the onset of ventricular fibrillation or pulseless ventricular tachycardia,[5] and so should be used only when the arrest is witnessed and monitored. There is no evidence that precordial thump improves recovery in unwitnessed cardiac arrest.[citation needed] It is also not useful against ventricular fibrillation after time has passed.[6] It has very low efficacy against ventricular arrythmia[7] (possibly even making it worse)[4][7] and ventricular tachycardia,[2] especially compared to the alternatives of CPR and defibrillation.
While the odds of success are poor, the procedure is rapid, allowing the provider to continue with other resuscitation procedures, including CPR, medication and defibrillation as appropriate.[citation needed]
Adverse effects and appearance
There are concerns that the precordial thump can result in worsening of a person's heart rhythm more often than it improves it.[2]
The use of the precordial thump technique has sometimes been shown in famous
At one time, the technique was also taught as part of standard CPR training with the requirement that it must be administered within 60 seconds of the onset of symptoms. That time restriction, combined with a number of injuries caused by improper technique,[citation needed] resulted in the procedure being removed from CPR training.
History
James E. Pennington and
Fist pacing
Percussion pacing or fist pacing was proposed as a method of delivering mechanical pacing to someone in cardiac arrest. There is little evidence to support its use.[9] In 1920, German physician Eduard Schott originally described percussion pacing, and a 2007 BJA article describes good benefit to this technique.[10]
References
- ^ PMID 26472989.
- ^ PMID 23994203.
- PMID 20956223.
- ^ PMID 7223609.
- PMID 6476543.
- PMID 19968931.
- ^ PMID 18952350.
- ^ Diehl, Digby (2000). "The Emergency Medical Services Program". To Improve Health and Health Care. Vol. 2000. Robert Wood Johnson Foundation. p. 21.
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ignored (help) - ^ "Guideline 11.3: Precordial Thump & Fist Pacing" (PDF). Index of Guidelines. Australian Resuscitation Council and New Zealand Resuscitation Council. July 2011. Archived from the original on October 6, 2011. Retrieved February 15, 2014.
- PMID 17327252.