Chest
Complications of Cardiac Resuscitation
Section snippets
METHODS
Paramedics from fire-rescue departments servicing Dade County, Florida, identified individuals undergoing prehospital resuscitation from Jan 1, 1977 through Aug 31, 1979. Fire department casualty reports and Medical Examiner investigative reports were reviewed daily and served as secondary sources of case identification. To qualify for inclusion, the following criteria had to be met; (1) trained personnel determined that the patient was in cardiac arrest; (2) the patient was responded to by
RESULTS
Of the 2,187 consecutive prehospital cardiac arrest patients identified during the study period, 705, or 32.2 percent, were autopsied by the Office of the Medical Examiner. These victims were predominantly men (70.7 percent) with a mean age of 45.6 years (Table 2). The arrest was often due to nonnatural causes (46.5 percent), either traumatic or nontraumatic (eg, vehicular accident, drowning, overdose), and CPR was given for more than 20 minutes (77.5 percent). The mechanical cardiocompressor
DISCUSSION
To put these findings into perspective, it is important to note that prehospital CPR, as currently practiced, includes external chest compressions and ventilation, as well as definitive emergency maneuvers (eg, defibrillation, drug administration), each of which has a strong potential for injurious consequences. Specifically, external chest compressions have been observed to result in fractures of the rib, cartilage, sternum, and cervical spine. Additionally, cardiac massage causes soft tissue
ACKNOWLEDGMENT
The authors gratefully acknowledge the County, and the cities of Miami, Coral Gables, Hialeah, and Miami Beach.
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This research was supported by the National Center for Health Services Research grant No. 02567.