What is the effectiveness of the precordial thump?
The following paper www.ncbi.nlm.nih.gov/pubmed/23994203 states that there was no effectiveness of the precordial thump in their study, if I read it correctly.
Questions:
Is this the medical consensus on this technique? What do other papers say? Does there exist a survey paper on advanced cardiac life support that perhaps has looked more into this particular technique?
Do medical schools in general teach this technique, in modern times? Do doctors tend to use this technique, in reality?
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Well I have successfully used a precordial thump to cardiorevert someone but that was long before we had things such as guidelines. And a crash cart was close by.
It is thought that it should only be used when witnessing the onset of ventricular fibrillation or pulseless ventricular tachycardia but it also has the unfortunate possibility of converting that rhythm to a more lethal rhythm such as asystole. But one study showed it worked the best in asystole. Presumably because it can't get worse.
The energy delivered by a thump in the correct location is about 5 Joules compared with e.g. 300 Joules from a defibrillator.
The number needed to treat is 13-50, but the numbers needed to make the rhythm worse is 2-10. So the patient will be better off statistically if you don't employ this technique.
canadiem.org/the-precordial-thump-good-bad-or-ugly/
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