Comments on: Storm, CPR, and the Precordial Thump

By: encephalopathy

encephalopathy — Tue, 19 Apr 2011 17:14:20 +0000

walked into resus last week as patient went into pulseless VT as i walked past the cubicle. whacked her on the chest and reverted her to NSR and she woke up.

2nd time it’s worked for me. secret is to hit very hard and almost bounce your fist back up off the chest

By: MR

MR — Wed, 28 Apr 2010 23:34:29 +0000

Ok, so I have paroxysmal atrial fib, rarely more than once every two or three years, and after jumping up to pee in the middle of the night, I had it again. Took over 300 mg of metoprolol over the next 24 hrs to keep my rate under 85 or so, plus ASA, but woke up the next morning still in afib (I am an ER doc, so I know afib when I have it). I was so pissed off that I might have had to go in for cardioversion that I actually hit myself in the chest out of frustration with my overly sensitive atrium… and yep, you guessed it, I immediately converted into sinus rhythm. It wasn’t from valsalva, I had tried that 10 minutes before without success. It was an unintended precordial thump (unless subconsciously I was trying this maneuver in deference to the two times I have converted asystole to supraventricular rhythms with serial thumps in other patients years ago). So, my N=1 of auto-cardioversion of rate-controlled paroxysmal atrial fib with self-administered precordial thump. Now I have to decide whether to try it again the next time – I suppose there is the risk of conversion to something far worse than afib, but there’s always tussive CPR as a backup.

By: TayJK

TayJK — Sun, 19 Jul 2009 23:49:38 +0000

Yeah, six, after the Chancellor got shot. He played with his gizmos, realized that he was going into come kind of arrest, then thumped him. Not sure if any CPR was used…

By: Joe

Joe — Sun, 19 Jul 2009 15:47:50 +0000

I swear I saw “Bones” McCoy do it to a Kingon in one of the Star Trek movies.. (VI?). I don’t think he did it right either.

By: J

Thu, 16 Jul 2009 22:49:20 +0000

It would be nice to read more of your very interesting med stories; the “True Tales of Medical School” section is rather lonesome for lack of updates : (

By: Marge

Marge — Thu, 16 Jul 2009 16:24:32 +0000

My mum recounts a story from the Dark Ages of medicine, when defibrilators where the size of small cars. Patient kept going into Vfib, but was a long way from surgery – so they ended up wheeling them through the corridors of the hospital, past patients and visitors, with my mum thwacking him on the chest every few minutes every time he went into VFib. So she’s done it dozens of times :)

By: Drafterman

Drafterman — Thu, 16 Jul 2009 13:28:14 +0000

Maybe I’ve been out of the comic seen too long. When did Storm become orange? Why are we not addressing this House-style medical mystery?

By: Sean Duggan

Sean Duggan — Wed, 15 Jul 2009 14:32:41 +0000

I guess that, in some ways, the precordial thump just resonates with people. Unlike things like CPR which require extensive training and following strict procedures, the thump seems like a primal expression of “Live, goddamit!” where we personally storm the gates of death through our sheer desire to save the victim. And it fits with our mental picture. When you hit someone, they bolt upright and gasp. Chest compressions just don’t conjure up the right image.

By: theOriginalKeith

theOriginalKeith — Wed, 15 Jul 2009 12:24:24 +0000

If you’re going to bring up Scrubs, you can’t ignore The Todd’s “Miracle Five”…

By: arkonbey

arkonbey — Wed, 15 Jul 2009 12:10:05 +0000

don’t be offended, but when reading your anecdote, all I could think of was the dream sequence in [Scrubs] where JD imagines that he is Fonzie waking a comatose patient with the lesser known Jukebox Thump.