Friday, August 19, 2011

Emedinews:Insights on Medicolegal issues:If needed the doctor must perform CPR even in patients with injury chest

• When a person is in need of CPR, it means that the person is in cardiac arrest i.e. they are unconscious, not moving, not breathing normally.
• If the person is awake, is breathing normally and therefore does not appear to need CPR, chest compressions and CPR may further damage the already damaged chest and complicate the victim’s injuries. As soon as the victim becomes unconscious, is not breathing normally and now appears to need CPR, Emergency Services would 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 guidelines even if the complications could include those of punctured lungs, lacerated organs, or bruised/punctured heart muscle. These injuries must be recorded in 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.

(Contributed by Dr Sudhir Gupta)

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