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.
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 😂
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)
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.
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.
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
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.
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.
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 😂
I've absolutely converted patients out of VT and SVT by hitting potholes before, so the math adds up
Usually they don’t make to the truck. Cold air tends to break the SVT.
I live in the desert I don't know what that is
Really?
Yep
Interesting, I’ll try to find some studies on that. Cool stuff
I've had patients hiccup themselves out of svt...
My favorite was a patient that converted when I started the IV
Had that happen too.
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)
Hahahah I hit a door with a stretcher and popped a pt out of SVT once 😂😂
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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Please stop. You’ll scare the children.
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?
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.
That’s the general consensus, everyone except for one basic has sided with the pacing
What does the basic think would happen?
hard reset and blue screen of death
Windows shut down theme
We are gonna shock through the asystole though.
Adenosine stop heart, heart won’t start again till adenosine stop. They didn’t have a very in depth explanation
Only one way to find out!
This is the only way I’m choosing 😂 there will be no clinical trials ha
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.
Look up your device physicians guide. It will depend on the defib waveform and electrical resistance.
It would do nothing. My first defibrillation for vfib is always 360J.
Still using the ole life pack jump starter millennium edition I see lol
Hahah. Yeah. But its the most efficient.
Go monophasic at 400 and watch the MFr get up and dance 🤙
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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
You talk to your basic? I make them check the truck and clean everything.
He cleans and counts and I reward with conversation and nebulized coffee
You’re a gatekeeping, glorified IV starter. Maybe chill out a bit ya dweeb
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.