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precordial thump
I’m ready to thump someone!

The precordial thump is a technique by which a health care professionals thumps the chest of a patient in ventricular fibrillation or pulseless ventricular tachycardia when a defibrillator is not present.  It has a low success rate as the energy generated from even the most vicious punch doesn’t translate into enough joules; for this very reason, the People’s Elbow is preferred.  Despite the failure rate of the precordial thump, the idea of punching a patient as hard as you can has led to other subspecialties developing lesser-known variants of the precordial thump.  How many of these have you tried?

Preabdominal thump – With a success rate of 0.000001%, the preabdominal thump may be used in the most refractory cases of abdominal pain, nausea, vomiting, constipation, or diarrhea.

Precarotid thump – Also known as a sucker punch, this is frequently used to take down an aggressive patient.  Interestingly enough, a favorite maneuver of members of the palliative care team.

Precranial thump – Essentially similar to smacking a TV, computer, or other device when it isn’t working properly, the precranial thump involves a licensed neurologist slapping a patient with seizures or pseudoseizures upside the head to get them to stop.

Predental thump – The most blunt way dentists and oral maxillofacial surgeons remove cavities.

Predermal thump – Probably the most frequently used of these thumps, also known as “pimple popping.”

Preextremity thump – A last ditch effort by vascular surgeons to treat compartment syndrome, critical limb ischemia, or peripheral vascular disease.

Prenasal thump – An unproven methodology to offset postnasal drip.

Preocular thump – Administered by ophthalmologists in the field to treat sudden vision loss.

Prepenile and pretesticular thumps – Theoretical methods to treat erectile dysfunction.

Preradial thump – Used by respiratory therapists when an ABG is proving difficult.

Prerectal thump – A rarely used option to treat constipation when lactulose and GoLYTELY have failed.

Prerenal thump – Only used by seasoned nephrologists and urologists to dislodge kidney stones.

Pretracheal thump – Slightly more successful than the precordial thump, pulmonologists recommend this in the event of a tracheal obstruction from a foreign body without immediate access to a bronchoscope.

Prevaginal or preuterine thumps – An OB/GYN’s “kitchen sink” maneuver to treat abnormal uterine bleeding or technically-difficult labor.

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Dr. 99
First there was Dr. 01, the first robot physician, created to withstand toxic levels of burnout in an increasingly mechanistic and impossibly demanding healthcare field. Dr. 99 builds upon the advances of its ninety-eight predecessors by phasing out all human emotion, innovation, and creativity completely, and focusing solely on pre-programmed protocols and volume-based productivity. In its spare time, Dr. 99 enjoys writing for Gomerblog and listening to Taylor Swift.