Precordial punch

The precordial fist or precardial punch is a form of cardioversion that can be attempted during cardiopulmonary resuscitation to break an existing cardiac arrest . The mechanical energy of the beat (about 5 joules ) is supposed to convert ventricular fibrillation , ventricular flutter or ventricular tachycardia into a regular sinus rhythm .

The precordial thump is in the resuscitation guidelines of the European Resuscitation Council recommended only for medical professionals and even then only if the occurrence of cardiac arrest immediately before right on ECG - monitor was observed. The little finger or the ulnar side of the fist is hit once from a height of about 15 to 20 centimeters on the middle to lower part of the sternum (transition from the middle to the lower third) and immediately pulled back so that an impulsive force is applied.

There are no prospective studies that prove the effectiveness of the precordial punch. The precordial punch was found to be ineffective in treating ventricular tachyarrhythmias . The maneuver was first published in 1920 by the Cologne doctor Eduard Schott and described in detail in 1970 by James E. Pennington, Jack Taylor and Bernard Lown .

Individual evidence

^ P. Kohl, AM King, C. Boulin: Anti arrhythmic effects of acute mechanical stimulation. In: P. Kohl, F. Sachs, MR Franz (eds.): Cardiac mechano-electricfeedback and arrhythmias: from pipette to patient. Elsevier Saunders, Philadelphia 2005, pp. 304-314.
↑ CD Deakin, JP Nolan; European Resuscitation Council: European Resuscitation Council guidelines for resuscitation 2005. Section 3. Electrical therapies: automated external defibrillators, defibrillation, cardioversion and pacing. In: Resuscitation. Suppl 1, 2005, pp. 25-37. PMID 16321714 .
↑ O. Amir, JE Schliamser, S. Nemer, M. Arie: ineffectiveness of precordial thump for cardioversion of malignant ventricular tachyarrhythmias . In: Pacing Clin Electrophysiol . tape 30 , no. 2 , February 2007, p. 153-156 , doi : 10.1111 / j.1540-8159.2007.00643.x , PMID 17338709 .
↑ E. Schott: About ventricular arrest (Adams-Stokes attacks) together with remarks about other types of arrhythmias of a temporary nature . In: German Archive for Clinical Medicine . tape 131 , 1920, pp. 211-229 .
^ JE Pennington, J. Taylor, B. Lown: Chest thump for reverting ventricular tachycardia . In: N. Engl. J. Med. Band 283 , no. 22 November 1970, p. 1192-1195 , doi : 10.1056 / NEJM197011262832204 , PMID 5472940 .

[Kohl-1] P. Kohl, AM King, C. Boulin: Anti arrhythmic effects of acute mechanical stimulation. In: P. Kohl, F. Sachs, MR Franz (eds.): Cardiac mechano-electricfeedback and arrhythmias: from pipette to patient. Elsevier Saunders, Philadelphia 2005, pp. 304-314.

[Deakin-2] CD Deakin, JP Nolan; European Resuscitation Council: European Resuscitation Council guidelines for resuscitation 2005. Section 3. Electrical therapies: automated external defibrillators, defibrillation, cardioversion and pacing. In: Resuscitation. Suppl 1, 2005, pp. 25-37. PMID 16321714 .

[3] O. Amir, JE Schliamser, S. Nemer, M. Arie: ineffectiveness of precordial thump for cardioversion of malignant ventricular tachyarrhythmias . In: Pacing Clin Electrophysiol . tape 30 , no. 2 , February 2007, p. 153-156 , doi : 10.1111 / j.1540-8159.2007.00643.x , PMID 17338709 .

[4] E. Schott: About ventricular arrest (Adams-Stokes attacks) together with remarks about other types of arrhythmias of a temporary nature . In: German Archive for Clinical Medicine . tape 131 , 1920, pp. 211-229 .

[5] JE Pennington, J. Taylor, B. Lown: Chest thump for reverting ventricular tachycardia . In: N. Engl. J. Med. Band 283 , no. 22 November 1970, p. 1192-1195 , doi : 10.1056 / NEJM197011262832204 , PMID 5472940 .