|
Author |
Jennie Helmer |
Date |
2019-08-01 |
|
Reviewer |
- |
Edited |
2020-10-22 |
You respond to a 48yom who is complaining of a central sternal crushing pain that came on while he was vacuuming his house. As you approach the patient, you note that he is pale and diaphoretic. Suddenly he becomes unresponsive and he appears to be gasping for breath (agonal breathing). You check for a carotid pulse and cannot find one. Your partner has not yet turned on the monitor, but scrambles to do so now.
Should the paramedic who is by the patient’s side perform a precordial thump, with a well-placed fist, in the hopes of providing enough Joules to convert the rhythm out of what is likely VF/VT or should the paramedic start chest compressions while the partner readies the monitor and applies the defibrillator pads.
“In adult OHCA patients with an EMS-witnessed CA, does the precordial thump versus standard CPR lead to differences in ROSC?”
|
Population |
Adult OHCA patient with an EMS-witnessed CA |
|
Intervention |
Precordial Thump |
|
Comparison |
Standard CPR |
|
Outcome |
Return of Spontaneous Circulation |
PubMed: ((Fist pacing OR Precordial Thump)) AND Cardiac Arrest
PubMed: (prehospital OR out-of-hospital) AND (fist-pacing OR precordial thump) AND (ROSC OR Return of Spontaneous Circulation)
33 Results (3 Relevant) on 2019-08-01
These three papers do not provide supportive evidence for the use of the Precordial Thump in EMS-witnessed cardiac arrests. One paper concluded that the use of the PT in OHCA rarely results in immediate ROSC, and is more commonly associated with rhythm deterioration.