Cardiopulmonary Resuscitation-Related Head Trauma: A Case Report

Pub Date : 2023-10-19 DOI:10.3390/reports6040050
Ilina Brainova, Pavel Timonov, Antoaneta Fasova, Alexandar Alexandrov
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Abstract

Introduction: In all cases of cardiac arrest, adequate cardiopulmonary resuscitation (CPR) performance is crucial for survival. There are differences between the performances of CPR in pediatric cases compared to CPR in adults. In all cases in which CPR is needed, there is a possibility for the occurrence of CPR-related traumatic injuries. Aims and methods: We used all available forensic examination methods in order to provide objective forensic investigation conclusions and feedback to clinicians. Results: We present an untypical case of head trauma with intracranial bleeding caused via CPR-related traumatic injury. Although it is not connected with the mechanism and genesis of death, it should be noted as being practically casuistic. The child had a severe congenital heart malformation. The surgical team decided that surgery was absolutely necessary. Complications developed in the postoperative period. On the second postoperative day, cardiac arrest occurred, CPR was performed, and the girl survived for 15 minuntil there was a second cardiac arrest. A second CPR was performed, but she died. During the forensic autopsy, with the exception of expected findings, head bruising and intracranial bleeding were registered. Conclusion: The forensic conclusion was that the head trauma was caused accidentally during CPR due to the non-voluntary impact of the head with respect to the background of anticoagulant therapy, which was one possible factor for the massive bleeding.
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心肺复苏相关头部创伤1例报告
在所有心脏骤停的病例中,适当的心肺复苏(CPR)表现对生存至关重要。与成人心肺复苏术相比,儿童心肺复苏术的表现存在差异。在所有需要心肺复苏术的病例中,都有可能发生与心肺复苏术相关的创伤性损伤。目的和方法:利用现有的法医检验方法,为临床医生提供客观的法医调查结论和反馈。结果:我们报告了一例非典型的颅脑外伤合并颅内出血的病例。虽然它与死亡的机制和起源没有联系,但应该指出它实际上是诡辩的。这孩子有严重的先天性心脏畸形。手术小组认为手术是绝对必要的。术后出现并发症。术后第二天,发生心脏骤停,进行了心肺复苏术,女孩存活了15分钟,直到第二次心脏骤停。医生给她做了第二次心肺复苏术,但她还是死了。在法医尸检期间,除了预期的发现外,还记录了头部瘀伤和颅内出血。结论:法医学结论认为,在抗凝治疗的背景下,由于头部的非自愿撞击,是心肺复苏术中意外造成的头部创伤,这可能是导致大出血的原因之一。
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