A precordial thump should be considered if cardiac arrest is confirmed rapidly following a witnessed and monitored (ECG) sudden collapse (VF or VT) if the defibrillator is not immediately at hand (Resuscitation Council (UK), 2006).

When do you use precordial thump?

Precordial thump may be effective only if used within seconds near the onset of ventricular fibrillation or pulseless ventricular tachycardia, and so should be used only when the arrest is witnessed and monitored. There is no evidence that precordial thump improves recovery in unwitnessed cardiac arrest.

Is precordial thump still recommended for VT or VF?

The American Heart Association (AHA) currently recommends the precordial thump as the initial maneuver in treatment of ventricular tachycardia (VT) and monitored ventricular fibrillation (VF). These recommendations are based largely on anecdotal reports of successful "thump-version" of asystole, VF, and VT.