AnthonyM83 Posted August 30, 2006 Share Posted August 30, 2006 I was wondering: What's the deal with the heart thump? A few years ago, in high school, I was on a field trip where one of the kids collapsed. Apparently, he didn't have a pulse, but some other peers, fellow teenagers, restarted it with a heart thump. I didn't get to witness it, as I didn't know anything was wrong until I saw EMS arrive. I never heard this mentioned in my EMT school, so I'm guessing it's outdated or out of scope. If it's outdated, why? Something reminded me of it just now, so I thought I'd ask. PS Apparently, the victim had a pre-existing heard condition...don't know more details. Link to comment Share on other sites More sharing options...
JPINFV Posted August 30, 2006 Share Posted August 30, 2006 Precordial chest thump has been studied in a number of case series for patients in pulseless VT and VF. It has been found to convert VT and VF to a perfusing rhythm in some cases, but it also has converted VT to VF and VF to asystole in other cases. This intervention is no longer routinely recommended. http://www.emedicine.com/emerg/topic633.htm Thumping doesn't work [s:7d7b1c077d]well[/s:7d7b1c077d] in Swine, apparently: http://news.healingwell.com/index.php?p=news1&id=525548 Interesting article on the Thump and "fist pacing" from down under [PDF] http://www.resus.org.au/public/guidelines/...rdial_thump.htm I get the sense that the thump is next to useless, but takes no time to perform, so it's a nothing lost, almost nothing gained situation. Link to comment Share on other sites More sharing options...
itxtme Posted August 30, 2006 Share Posted August 30, 2006 Current guidelines down here suggest it purely as a measure only if a defibrillator is not immediately available. Considering all responders have at least an AED on board the only time I can ever see it being used is when the defib breaks and will not function, however I am yet to here of a situation where this has been the case!! Link to comment Share on other sites More sharing options...
Dustdevil Posted August 31, 2006 Share Posted August 31, 2006 Even if your AED is "immediately available," it will take you a minimum of one minute to deploy it onto your patient. With every passing minute, you lost another ten-percent chance of resuscitation. Think about it. Link to comment Share on other sites More sharing options...
hammerpcp Posted August 31, 2006 Share Posted August 31, 2006 "Among the 29 animals, the researchers were able to induce 31 cases of cardiac arrest, according to the report....." Does anyone else see a problem? It doesnt take me a minute to apply the SAED, maybe you're getting slow in your old age. :notworthy: Link to comment Share on other sites More sharing options...
JPINFV Posted August 31, 2006 Share Posted August 31, 2006 "Among the 29 animals, the researchers were able to induce 31 cases of cardiac arrest, according to the report....." Does anyone else see a problem? Maybe they induced arrest, revived with a defibrillator, then had another go at it. Hell, hoisting pigs and hitting them with base balls from a pitching machine sounds like fun. :twisted: Link to comment Share on other sites More sharing options...
Dustdevil Posted August 31, 2006 Share Posted August 31, 2006 I'm not talking about applying the AED. I'm talking about delivering the shock. That will take you at least a minute from arrival at patient's side until deployment. Link to comment Share on other sites More sharing options...
SSG G-man Posted August 31, 2006 Share Posted August 31, 2006 Anyone remember the episode of Emergency! that dealt with this? Two guys are friends, one thinks the other is having a heart attack so he hits the guy on the chest. Admits to having seen it on TV. Broke some ribs. While buddy is in the hospital, friends to visit. While leaning over the bed the "victim" punches him in the face, saying some thing to the effect, of it was payback from the broken ribs. I do not know what season it was from. Not season 1 or 2 I have those on DVD. Anxiously awaiting the next installment!! Sarge Link to comment Share on other sites More sharing options...
snakemedic Posted August 31, 2006 Share Posted August 31, 2006 It is my understanding that the "thump" at least from ACLS prospective can be delivered when in the presence of a witnessed cardiac arrest and immediate access to defibrillation is not available. It is not so much a common practice on the road as most times you have access to your defibrillator, but perhaps it might be more common in a hospital setting where someone is sent for the crash cart. A Canadian perspective? Snakemedic Link to comment Share on other sites More sharing options...
itxtme Posted August 31, 2006 Share Posted August 31, 2006 I'm not talking about applying the AED. I'm talking about delivering the shock. That will take you at least a minute from arrival at patients side until deployment. And if it doesn't work!? One could argue that's another 30 seconds you have taken to correctly give the thump. So they now have a 15% less chance of survival. I have not got time tonight to look at stats on successful reverts from the thump so would be interesting to see the survival statistics. I personally feel that defibrillation, having a higher success rate the earlier it is done, is always going to be the better option, however if you have to stand around waiting for it to be handed to you and there is time for a chest thump why not? Surely guidelines aren't written without clinical facts taken into consideration!? Link to comment Share on other sites More sharing options...
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