Precordial Thumping During Cardiac Resuscitation

Abstract

A forceful blow to the precordium has been recommended as the first resuscitative measure following diagnosis of cardiac arrest. This is the result of sporadic reports that precordial thumping was followed by recovery of patients thought to have cardiac arrest. In 1920, Schott first reported that a blow to the chest restored a palpable pulse in a patient with an Adams- Stokes attack (1). Since that time, supporting testimonials have failed to establish adequately the conditions existing at the time of treatment. Scherf and Bornemann in 1960 suggested that precordial thumping revived ventricular automatism during cardiac standstill (2). They demonstrated electrocardiographic tracings showing single and multiple ectopic depolarizations following blows to the precordium in 11 patients thought to have cardiac standstill. Three of the 11 patients were resuscitated. In one of the three survivors, circulatory arrest at the time of thumping was questionable.