<- Home <- Arhive <- Vol. 22, Issue 4, December 2014

Rom J Leg Med22(4)221-223(2014)
© Romanian Society of Legal Medicine

Tension pneumothorax in unsuccessful cardiopulmonary resuscitation

C. T. Buschmann, M. Tsokos, C. Kleber

Abstract: Background. A well-known complication of cardiopulmonary resuscitation (CPR) and a potentially reversible cause of cardiac arrest (CA) is tension pneumothorax (TP). In TP external cardiac massage is ineffective because increased intrathoracic pressures hamper passive diastolic filling of the heart.
Case Reports. As forensic practice reveals repeated cases of unsuccessful CPR with co-existing TP, we exemplarily describe 4 cases of unsuccessful CPR from different origins with TP, which prevented CPR from positive outcome. Why should a forensic pathologist be aware of this? Not only complications of medical therapies are of medico-legal relevance, but also omission of procedures. Autopsy cases with TP after CPR should be discussed regarding medical malpractice. Bilateral chest decompression before termination of CPR must be considered in all patients with CA and blunt chest trauma, i.e. external cardiac massage.
Keywords: cardiopulmonary resuscitation, tension pneumothorax, chest trauma, chest decompression, autopsy.

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