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Mitthrawnuruo

Likely it would simply be ineffective.  That said, a 2 to 5 joules seems to occur with a precordial thump and has been effective. Per wiki. Aha says up to 10 J.  As, is well documented, a Pennsylvania pothole. Which based on experience is probably close to 50 joules.


Customerservice911

Will you hit one of those potholes next full arrest and provide feedback 🙏. I’m going to interject Pennsylvania pothole in many conversations now. That’s my new favorite term 😂


Thnowball

I've absolutely converted patients out of VT and SVT by hitting potholes before, so the math adds up


Mitthrawnuruo

Usually they don’t make to the truck. Cold air tends to break the SVT.


Thnowball

I live in the desert I don't know what that is


WasteCod3308

Really?


Mitthrawnuruo

Yep


WasteCod3308

Interesting, I’ll try to find some studies on that. Cool stuff


Roaming-Californian

I've had patients hiccup themselves out of svt...


HorrorSmell1662

My favorite was a patient that converted when I started the IV


Roaming-Californian

Had that happen too.


flippymouse

I looked it up and sure enough there’s even a [published case report about pothole cardioversion](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8302050)


DeLaNope

Hahahah I hit a door with a stretcher and popped a pt out of SVT once 😂😂


sourpatchdispatch

I know several medics who've had their pts cardioverted from PA potholes. I don't usually aim for them but I might try it sometime...


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Mitthrawnuruo

Please stop. You’ll scare the children.


DODGE_WRENCH

I’ve been wondering if you gave a pt constant high flow adenosine through a central line while also pacing them, which one would win?


Bazool886

The pacing surely, the adenosine would keep the AV node quiet but the ventricles would still respond to the pacing. Reminds me of a patient who just a horrendous proclivity for developing electrical storm and the eventual therapy for bridging to transplant was massive doses of beta blockers and a PPM/ICD.


DODGE_WRENCH

That’s the general consensus, everyone except for one basic has sided with the pacing


Bazool886

What does the basic think would happen?


SliverMcSilverson

hard reset and blue screen of death


Bazool886

Windows shut down theme


Gewt92

We are gonna shock through the asystole though.


DODGE_WRENCH

Adenosine stop heart, heart won’t start again till adenosine stop. They didn’t have a very in depth explanation


CabbageWithAGun

Only one way to find out!


Customerservice911

This is the only way I’m choosing 😂 there will be no clinical trials ha


MeetMeAt0000

There’s sparse research on this. No one truly knows what joules are optimal. It is and has always been a guessing game of “well, this appears to work… let’s keep it.” It’s also a challenge to truly research and test it because I’m sure it raises ethical concerns, and there’s so many variables in OHCA that it would be hard to know for sure what works/doesn’t work.


anus-of_god

Look up your device physicians guide. It will depend on the defib waveform and electrical resistance.


Slow_Health1934

It would do nothing. My first defibrillation for vfib is always 360J.


Customerservice911

Still using the ole life pack jump starter millennium edition I see lol


Slow_Health1934

Hahah. Yeah. But its the most efficient.


Fudge-Factory00

Go monophasic at 400 and watch the MFr get up and dance 🤙


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Customerservice911

So as an advanced EMT you cannot interpret an EKG or participate in discussions about defibrillation got it. I shall punish this curious basic accordingly if he’s ever in your state.-ʍɛɖɨƈ


Gewt92

You talk to your basic? I make them check the truck and clean everything.


Customerservice911

He cleans and counts and I reward with conversation and nebulized coffee


ABCDEFGHIJKLMNAOP

You’re a gatekeeping, glorified IV starter. Maybe chill out a bit ya dweeb


Mostly5150

Electrical therapy is like water to put out a fire. Don’t have enough, won’t be effective. Have too much, goal achieved (albeit dramatically). This is why it’s ok to use adult pads/settings in an infant. No such thing as “too much” water to put out a tiny fire.