Tuesday 16 April 2013

Emedinews:Insights on Medicolegal issues:Should a doctor perform CPR in already injured chest patient?



When a person needs CPR or cardiopulmonary resuscitation, this means that he/she is unconscious, not moving and not breathing normally. If this is the case, the person is presumably in cardiac arrest or in a state that justifies cardiopulmonary resuscitation.
  • If the person is awake, is breathing normally and therefore does not appear to need CPR, it would be correct that chest compressions and CPR may complicate the already damaged chest and further complicate the victim’s injuries.
  • As soon as the victim becomes unconscious, is not breathing normally and now appears to need CPR, Emergency Services should be contacted and CPR should be initiated regardless of the injuries of the patient.
  • If the person needs CPR, this means that they are clinically dead. If the victim does not receive CPR, they will simply graduate to permanent death.
  • This is why, regardless of the chest injury, if the person is "dead" or in need of CPR, compressions are to be given per the American Heart Association (AHA) guidelines even if the complications could include those of punctured lungs, lacerated organs or bruised/punctured heart muscle. These injuries must be recorded in the clinical sheet.
  • This would be based on the theory that a person in need of CPR is already dead and will not be harmed more even if there are negative side effects from providing chest compressions. If a person remains dead, surgery is not an option but if the person is resuscitated with CPR, and alive at the hospital, we have an opportunity to fix the injuries that may have been aggravated by doing CPR.

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