Frequency and number of resuscitation related rib and sternum fractures are higher than generally considered.

Abstract:

AIM OF THE STUDY:This study aimed to establish the incidence, number and location of CPR-related skeletal chest injuries (SCI) and to investigate the influence of age, gender, changes in resuscitation guidelines and technique of resuscitation. METHODS:We analysed SCI in 2148 patients who had undergone resuscitation for non-traumatic cardiac arrest, as shown by autopsies performed at the Institute of Forensic Medicine in Ljubljana in the period 2004-2013. RESULTS:External cardiac massage caused SCI in 86% of males and in 91% of females; sternum fractures occurred in 59% of males and 79% of females, rib fractures in 77% of males and 85% of females and sternocostal separations in 33% of males and 12% of females. The average number of all SCI per person was thus almost the same in males and females: 10.95 vs. 10.96. The percentage of patients injured and the number of SCI increased with age. Changes in resuscitation guidelines were also identified as a factor contributing to the incidence and number of SCI. No adverse effect of the use of LUCAS was found. CONCLUSION:It is generally considered that at least 1/3 of resuscitated patients sustain rib fractures and at least 1/5 sustains sternum fractures. However, our study showed that these injuries are much more frequent and that increased compression rate and depth cause more SCI. Since in the period 2011-2013 accompanying severe injuries occurred in only 1.85% of cases, the resuscitation technique has not yet jeopardised patient's safety, but further close monitoring is needed.

journal_name

Resuscitation

journal_title

Resuscitation

authors

Kralj E,Podbregar M,Kejžar N,Balažic J

doi

10.1016/j.resuscitation.2015.02.034

subject

Has Abstract

pub_date

2015-08-01 00:00:00

pages

136-41

eissn

0300-9572

issn

1873-1570

pii

S0300-9572(15)00113-6

journal_volume

93

pub_type

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