Injuries associated with cardiopulmonary resuscitation


Authors: Lucie Ihnát Rudinská 1;  Petr Hejna 2;  Peter Ihnát 3,4;  Margita Smatanová 1;  Igor Dvořáček 1;  Anatolij Truhlář 5,6
Authors‘ workplace: Ústav soudního lékařství FN Ostrava 1;  Ústav soudního lékařství LF UK a FN Hradec Králové 2;  Chirurgická klinika FN Ostrava, Česká republika 3;  Katedra chirurgických oborů, LF OU Ostrava, Česká republika 4;  Zdravotnická záchranná služba Královéhradeckého kraje, Hradec Králové 5;  Klinika anesteziologie, resuscitace a intenzivní medicíny, LF UK a FN Hradec Králové 6
Published in: Soud Lék., 59, 2014, No. 3, p. 28-33
Category: Original Article

Overview

Introduction:
Therapeutic procedures performed during cardiopulmonary resuscitation on patients in cardiac arrest or unconsciousness from any other cause can have serious adverse effects. Scale of injuries scale is very wide – from simple skin lacerations up to serious injuries which can even thwart possibility of successful resuscitation and cause death.

Materials and methods:
Comprehensive review of current literature aimed at injuries associated with cardiopulmonary resuscitation.

Results:
Authors of this paper offer up-to-date review of possible cardiopulmonary resuscitation associated injuries, which are discussed depending on the method of performed resuscitation – airway management, chest compressions without tools or with automated mechanical devices, and defibrillation. Airway management is frequently associated with subcutaneous hematomas of the neck and head, mucosal membrane lacerations, teeth fractures and airway aspiration. Autopsy findings after cardiac massage are: rib and sternal fractures (very frequent); pleura, lung and cardiac injuries (frequent); cervical spine injuries, pericardial tamponades due to cardiac or aorta rupture, liver, spleen or stomach lacerations (rare). Defibrillation can create skin burns, cardiac or renal injuries due to rhabdomyolysis.

Conclusion:
Forensic pathologists as well as clinical practitioners should be aware of the relevance of possible injuries associated with cardiopulmonary resuscitation. The injuries should be avoided if possible, or distinguished from injuries of other origin if they cannot be prevented.

Keywords:
cardiopulmonary resuscitation – injury – airway management – chest compressions – defibrillation


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Labels
Anatomical pathology Forensic medical examiner Toxicology
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