Abstract
BackgroundCardiopulmonary resuscitation (CPR) provides a significant increase in survival rate, even if performed by bystanders. However, bystanders may refrain from performing CPR for fear of eventual malpractice litigation. Currently lack Guidelines specifying whether a particular CPR-related complication is in all likelihood unavoidable or not. To fulfill this gap a great number of studies is required to be published in the most relevant leading academic literature. This paper aims at making a contribution to addressing such a challenge.MethodsA retrospective observational study based on forensic autopsy material aiming at recording injuries resulting from the application of CPR. The severity of injuries was forensically evaluated.ResultsOut of 88 cases autopsied, only 26.7% had rib fractures (only 20% of which were located in the 6 lower ribs), 17.4% had sternal fractures (85.7% of which were detected in the body of the sternum and 14.3% in the manubrium). The ratio of sternal fractures to rib fractures is similar to the ratio cited in other studies reported in the literature (2:3, approximately). The number of fractures was 7.86 (4.11 on the right side and 4.75 on the left side). 16% of the cases were found to be mild, 48% were moderate, and 35% of the cases were severe. When a physician was present, a (not statistically significant) trend towards more severe complications was found.ConclusionThe findings are in accordance with other similar studies reported in the literature referring to the classic external CPR. This study offers a proposal aiming at making a contribution to develop Guidelines specifying whether a particular CPR-related complication is in all likelihood unavoidable or not.
Highlights
Cardiopulmonary resuscitation (CPR) provides a significant increase in survival rate, even if performed by bystanders
Incidence and location of the injuries All the CPR-related rib fractures involved in our autopsy findingswere located in the midclavicular line
It is crucial to bear in mind that it would be a difficult task to accurately determine the incidence of CPR-related rib and sternal fractures
Summary
Cardiopulmonary resuscitation (CPR) provides a significant increase in survival rate, even if performed by bystanders. Lack Guidelines specifying whether a particular CPR-related complication is in all likelihood unavoidable or not. To fulfill this gap a great number of studies is required to be published in the most relevant leading academic literature. Cardiopulmonary Resuscitation (CPR) constitutes one of the most important interventions at the socio-medical level It is a simple procedure which, may result in significant increase of the rate of survival of patients who experience sudden cardiac arrest mostly due to coronary heart disease [1]. In case of cardiac arrest resuscitation attempts should continue until adequate spontaneous circulation is achieved or until the death of the patient is ascertained [2] These attempts may cause considerable injuries to patients, increasing rescuer’s exposure to legal risk [2]. There are several publications reporting rare complications of CPR concerning both adults and minors [7,8,9,10,11,12,13,14]
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