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To the Editor: Dr Maron and colleagues1 reported that ventricular tachycardia/fibrillation was identified in 36 of 82 cases of commotio cordis and that most were successfully resuscitated by an external defibrillator.
Time is of the essence in treating this lethal tachyarrhythmia, and external defibrillators are often unavailable. Thumpversion,2 or a manual thump to the precordium, has been shown to be effective in terminating both ventricular tachycardia and ventricular fibrillation.3 It might seem to be a paradox to treat commotio cordis, which is caused by a chest blow, by a second precordial thump. Caldwell et al,4 however, reported that thumpversion was efficacious in a prospective study of 5000 medical-surgical patients. Therefore, a chest blow is apparently a double-edged sword: it can cause sudden ventricular arrhythmias but also terminate them.
A similar prospective study of thumpversion in commotio cordis would thus be an important study because thumpversion could be applied instantaneously and easily by any trained rescuer at the scene when no external defibrillator is immediately available.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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