Ridryder 911 Posted August 31, 2006 Posted August 31, 2006 Why would it take more than 5 seconds to deliver it ? It is simple... measure from nose to chest .. approx..10-14 inches and deliver PCT.. done, it delivers approximately 4 joules.. and yes, I have seen it worked numerous times. R/r 911
itxtme Posted August 31, 2006 Posted August 31, 2006 I am quite happy to admit I am nowhere as experienced as anyone here so this is purely a question for knowledge.. Is their contra-indications for the thump? and Are there any significant co-morbidity's caused by smacking the absolute shiza out of someones chest? Like does it cause problems with say CPR if required after the thump?
NREMT-Basic Posted August 31, 2006 Posted August 31, 2006 Dust- I couldnt tell for sure. I trust and learn a great deal from your experience and knowledge base. Are you advocating the heart thump or fist pacing and if so under what circumstances. Always happy to add something to my tool kit. I just did CPR in an elderly woman today in the local public library until ALS arrived? Would a heart thump have been apporpriate or not so because of how fragile she was to begin with? I look forward to hearing what you have to say on the matter. Please PM so I dont miss your response.
paramedicmike Posted August 31, 2006 Posted August 31, 2006 It's to be used on a witnessed, monitored arrest. So you have the monitor attached and on to see the change from a (hopefully) perfusing to a shockable rhythm in order to use it. And then it needs to be done PDQ. If you find someone down and aren't sure how long s/he's been there, it's better to just start CPR and go that way. Hope this helps. -be safe.
Asysin2leads Posted August 31, 2006 Posted August 31, 2006 While I've never delivered a precordial thump, I've hear many reports that it can work quite well for a sudden onset of V-fib or pulseless V-tach. If you are SURE the person just arrested on you, then there is no contraindication for using it. If they are in a rhythm other than ventricular fibrillation, it won't make a difference if you smacked them around a little. Then again, if you're wrong and induce a myocardial contusion, well, that's some bad luck for you.
AnthonyM83 Posted August 31, 2006 Author Posted August 31, 2006 Why would it take more than 5 seconds to deliver it ? It is simple... measure from nose to chest .. approx..10-14 inches and deliver PCT.. done, it delivers approximately 4 joules.. and yes, I have seen it worked numerous times. R/r 911 Measure from nose to chest? So, one does it by measuring from nose even with variances in head/neck/chest size? Wouldn't it be better to just do it a certain distance above the sternum or something like that? Also, what's the legalities of adding this to my toolbox if I didn't learn it in EMT class?
Ridryder 911 Posted September 2, 2006 Posted September 2, 2006 The traditional way it was taught was to place the elbow toward the nose, and the fist should not be greater than 15 inches in height, so one would not "swinging" outward or reaching to far back to hit too hard... It does not take much to produce enough force.. R/r 911
BushyFromOz Posted September 5, 2006 Posted September 5, 2006 like mike said - witnessed monitored VF arrest Does the PCT have a similar effect in the myocardial cells as a moderate impact on the head does the reticular activating system? My understanding (recalling lost info from a class a long time ago!!) is the joules of energy expended on the tissues pushes the voltage gated ion channels to their threshold potential quicker and inducing a hopefully near normal action potential. In head impacts, the joules cause the pre synaptic bulb to dump neurotransmitter into the synaps and cause a brief period of confusion or unconciousness? Am i in the ball park?
NREMT-Basic Posted September 5, 2006 Posted September 5, 2006 The only time I have seen this done is in films and a few MASH episodes. Is it taught at any EMT level as a viable option to produce a cardiac rhythm compatible with life? I would be interested to know. I have been talking to EMT and Paramedic friends and of course they have all heard of it but no one i know has ever used this method. I know that the measuments etc have been gone over but it just seems so totally random...like walking up and kicking your hard-drive. I would love to hear more from those that have actually used it in the field. Thanks.
Dustdevil Posted September 5, 2006 Posted September 5, 2006 I know that the measuments etc have been gone over but it just seems so totally random...like walking up and kicking your hard-drive. LMAO!! That's actually an excellent analogy! Very appropriate. Sometimes it works. Sometimes it doesn't. And, if done correctly, it can't hurt. I actually use that technique on the station radio here everyday with great success! When I first learned CPR in the late 60's, it wasn't even called CPR yet. It was just "artificial respiration" performed with the victim on their face. :shock: But when I took Advanced First Aid in high school, they were teaching the PCT, and it was still part of standard CPR up through the late 70's. As already mentioned, it was only for witnessed arrests. It continued for a very long time as standard practise for medical professionals, even after it was taken from lay CPR. In fact, some still teach it. And yes, sometimes it works!
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