Emedinews:Insights on Medicolegal Issues:Resuscitation injuries in postmortem

Soft tissues injuries, nail marks, various contusions, rib fractures are common in both adults and children who have undergone cardiopulmonary resuscitation (CPR); however, potentially life-threatening injuries are rare.

·         The doctors performing the resuscitation go through a very exhaustive cycle of CPR and generally forget to put a note after resuscitation particularly if resuscitation is followed by death. Hence, a format with resuscitation details should be kept attached to clinical sheet by the doctors to

·         The pre-arrest history in a resuscitated adult often assists the doctor conducting the autopsy to interpret findings related with resuscitation.

·         In the cases of an infant or child, there may not be a reliable history. In this situation, it may be difficult if not impossible to distinguish resuscitation injuries from pre-existing accidental or inflicted trauma. It has been seen in some cases that had significant autopsy-documented injuries initially attributed to abuse like contusions and nail marks produced during resuscitation.

·         The State filed murder charges against the caretaker in each case. However, further history and review of the medical records suggested that resuscitation rather than pre-arrest trauma caused almost all of the injuries.

·         The State dismissed the charges in the first case. A western jury returned a "not guilty" verdict in the second.

·         It is essential to consider the entire history and not just autopsy findings during a death investigation by forensic doctor or any legal agency.