Document Detail

Off-patient assessment of pre-cordial impact mechanics among medical professionals in North-East Italy involved in emergency cardiac resuscitation.
MedLine Citation:
PMID:  22910435     Owner:  NLM     Status:  MEDLINE    
Pre-cordial thump (PT) relies on cardiac mechano-electric transduction to transform mechanically-delivered energy into an electrophysiologically relevant stimulus. Its use for emergency resuscitation has declined recent years, amidst concerns about effectiveness and side-effects. In addition, there is insufficient knowledge about bio-mechanical properties and mechanisms of PT. Using a PT-mechanics recorder, we measured PT off-patient among healthcare professionals (n = 58) in North-East Italy, and related this to retrospective information on self-reported PT outcomes. Impact-speed and peak-force were 4.7 ± 1.3 m s⁻¹ (2.2-7.8 m s⁻¹) and 394 ± 110 N (202-648 N), respectively. Average self-reported cardioversion rate by PT was 35%. No adverse events were stated. All but 3 of PT providers with self-reported cardioversion rates ≥50% had pre-impact fist-speeds of ≥3.7 m s⁻¹. In comparison with previously-reported data from UK and US (n = 22 each), self-reported success-rates and pre-impact fist-speeds were more similar to US (PT-induced cardioversion rate 27.7%; fist-speed 4.17 ± 1.68 m s⁻¹) than to UK participants (PT-induced cardioversion rate 13.3%; fist-speed 1.55 ± 0.68 m s⁻¹). Small cohort-size, retrospective nature of data-gathering, and 'self-selection bias' (participants who have used PT on patients) limits the extent to which firm conclusions can be drawn. Observations are compatible, though, with the possibility that pre-impact fist-speed may affect success-rate of PT. Thus, where PT is used for acute resuscitation, it is delivered because it is immediately 'at hand'. Negative side effects are rare or absent in witnessed cardiac arrest cases. Pre-impact fist-speed may be a determinant of outcome, and this could be trained using devices suitable for self-assessment.
Tommaso Pellis; Daniele Pausler; Martina Gaiarin; Eliana Franceschino; Avi Epstein; Christian Boulin; Peter Kohl
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Publication Detail:
Type:  Journal Article     Date:  2012-08-11
Journal Detail:
Title:  Progress in biophysics and molecular biology     Volume:  110     ISSN:  1873-1732     ISO Abbreviation:  Prog. Biophys. Mol. Biol.     Publication Date:    2012 Oct-Nov
Date Detail:
Created Date:  2012-10-30     Completed Date:  2013-11-25     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  0401233     Medline TA:  Prog Biophys Mol Biol     Country:  England    
Other Details:
Languages:  eng     Pagination:  390-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Ltd. All rights reserved.
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MeSH Terms
Cardiopulmonary Resuscitation / instrumentation,  methods*
Emergency Service, Hospital*
Health Personnel*
Mechanical Processes*
Outcome Assessment (Health Care)*
Grant Support
FS/12/17/29532//British Heart Foundation; PG/09/031/27221//British Heart Foundation

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