Why can't you issue a precordial thump to a patient with witnessed V-fib?

Question

Why can't you issue a precordial thump to a patient with witnessed V-fib?

Answer 1

Precordial thump doesn't always work and in some cases, may make the rhythm worse -- see page IV-64 of the 2005 ACLS guidelines: http://circ.ahajournals.org/cgi/reprint/...

In the mean time, you may be delaying perfusion by interrupting (or not initiating) chest compressions.

As you may know, even after electricity defibrillation, it is still recommended to resume CPR right away because minimizing interruptions in perfusion is key to a successful resuscitation.

Of course, in very selected circumstances (like having cardiac rhythm monitoring but no defib capabilities), giving one thump then start CPR right away is probably defensible.

Hope I answered your question.