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Precordial Thump - Medical Procedures Reference Library - redOrbit

Precordial Thump - Medical Procedures Reference Library - redOrbit | First Aid Training | Scoop.it

The precordial thump is an application of mechanical energy through a calculated strike to the torso when in a specific fatal heart rhythm. This procedure is used in very specific circumstances by highly trained health professionals with ACLS certifications.

The Procedure
While in the presence of a patient that is suffering a potentially fatal heart rhythm, a medical provider can strike a calculated point on the sternum to disrupt that rhythm. The energy transferred by the provider is estimated to be 2 to 5 joules, which is enough to depolarize the heart and stop the fatal rhythm. While it will work, there are several factors to the success. The procedure must be performed early on in the onset of the fatal rhythm, the change must be witnessed to administer and it can only be performed once. The procedure should not be performed if it delays cpr or defibrillation. The provider should immediately proceed with the correct ACLS protocols for the patient condition.

What are the Fatal Rhythms
There are only two rhythms that are appropriate for the precordial thump and neither has a palpable pulse. The rhythms are ventricular fibrillation and pulseless ventricular tachycardia.

Possible Problems with the Procedure
The procedure is known to the layperson from television and it looks simple but done incorrectly can cause harmful injuries. The blunt trauma delivered to the wrong area can cause a break in the sternum or cardiac arrest. Even if done correctly, there is a chance that the rhythm will change into a more fatal rhythm, asystole. Asystole is where the heart is absent of any electricity and not beating.

Because of the number of injuries sustained by improper technique, the precordial thump was removed from standard CPR training and isn’t usually taught as a standard treatment.

 

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Understanding Sudden Cardiac Arrest

Understanding Sudden Cardiac Arrest | First Aid Training | Scoop.it

Sudden cardiac arrest is often confused with a heart attack. Although a prior heart attack increases one’s risk for sudden cardiac arrest, the two are quite different, with distinct risk factors, treatment options and outcomes.

Anatomy of a Heart Attack

A circulation problem of the heart causes a heart attack when one or more of the arteries delivering blood to the heart are blocked. Oxygen in the blood cannot reach the heart muscle, and the heart muscle becomes damaged. You can think of a heart attack as a “plumbing problem” in the heart.

This damage to the heart muscle can lead to disturbances of the heart’s electrical system. And a malfunction of the heart’s electrical system may cause dangerously fast heart rhythms that can lead to sudden cardiac arrest.

Anatomy of Sudden Cardiac Arrest

In contrast to a heart attack, sudden cardiac arrest is caused by an “electrical problem” in the heart. It occurs when the heart’s lower chambers (ventricles) suddenly develop a rapid, irregular rhythm (ventricular fibrillation) causing the ventricles to quiver rather than contract. The chaotic quivering motion of the ventricles renders the heart an ineffective pump that can no longer supply the body and brain with oxygen.

Within seconds, the person loses consciousness and has no pulse. Only immediate emergency treatment, such as cardiopulmonary resuscitation (CPR) and external defibrillation, can prevent death from sudden cardiac arrest. Time is key to surviving sudden cardiac arrest, with chances of survival decreasing about 10 percent every minute without defibrillation. The American Heart Association recommends defibrillation within five minutes of collapse or sooner.

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