Percussion Pacing?

[Jeepluv77]

Wow. This is a cool thing to read about. I'm going to have to ask my instructor on monday now. It's amazing the things that can work to bring back a patient.

[Richard B the EMT]

Due to my longevity in being an EMT, I recall we had the "Pre-Cardial Thump", done at the start of CPR. It was kind of as Ridryder described, a body-generated joules shock to the heart.

It was taken out of protocols, probably because too many civilians were breaking patient's ribs by doing it as "taught" by observation of it as done by our friends on LACoFD Rescue 51, Johnny and Roy. Because they saw it dramatized on "Emergency!", they believed they were doing it correctly.

Give them credit, as they at least tried to do something to help.

[mobey]

Due to my longevity in being an EMT, I recall we had the "Pre-Cardial Thump", done at the start of CPR. It was kind of as Ridryder described, a body-generated joules shock to the heart.

It was taken out of protocols, probably because too many civilians were breaking patient's ribs by doing it as "taught" by observation of it as done by our friends on LACoFD Rescue 51, Johnny and Roy. Because they saw it dramatized on "Emergency!", they believed they were doing it correctly.

Give them credit, as they at least tried to do something to help.

The precordial thump is still acceptable by ACLS standards in the event of a witnesed arrest, with no defib available.

Edited June 27, 2009 by mobey

[Jeepluv77]

We were "taught" how to do it in class, but I would probably never try it because we never practiced it or were taught how much strength to put behind it. Plus, last thing I'd want to do is miss and put someone's xyphoid process through their heart or lung. I think I'll stick with good ol' cpr and high flow diesel.

[AnthonyM83]

Due to my longevity in being an EMT, I recall we had the "Pre-Cardial Thump", done at the start of CPR. It was kind of as Ridryder described, a body-generated joules shock to the heart.

It was taken out of protocols, probably because too many civilians were breaking patient's ribs by doing it as "taught" by observation of it as done by our friends on LACoFD Rescue 51, Johnny and Roy. Because they saw it dramatized on "Emergency!", they believed they were doing it correctly.

Give them credit, as they at least tried to do something to help.

We had a nurse order it over the phone once.

Also had a friend do it under physician's direction in the ER upon her recommending it (pads weren't on yet). Converted the guy.

[Job13_5]

It works, I've done it. Although, I found that more force needed to be applied than the prescribed "let your fist drop onto pt's chest," making it more of a precordial thump, but aimed just left of the lower end of the sternum. I'd say I used moderate force with my hand 6-8" above pt chest, and it definitely produced perfusing pacing beats.

Attached is a snippet of the strip. The difference in beats, seemed to be related to the force used.

With percussion pacing, though, I imagine you would have to worry about R on T phenomenon, or commotio cordis...

[akroeze]

It works, I've done it. Although, I found that more force needed to be applied than the prescribed "let your fist drop onto pt's chest," making it more of a precordial thump, but aimed just left of the lower end of the sternum. I'd say I used moderate force with my hand 6-8" above pt chest, and it definitely produced perfusing pacing beats.

Attached is a snippet of the strip. The difference in beats, seemed to be related to the force used.

With percussion pacing, though, I imagine you would have to worry about R on T phenomenon, or commotio cordis...

Do your protocols allow for it?

What made you decide to do this rather than putting the pads on and electrically pacing?