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CRITICAL CARE AND TRAUMA

Cardiopulmonary Resuscitation Performed by Bystanders Does Not Increase Adverse Effects as Assessed by Chest Radiography

Elisabeth Oschatz, DrMed^*, Patrick Wunderbaldinger, DrMed, Fritz Sterz, DrMed^*, Michael Holzer, DrMed^*, Julia Kofler, DrMed^*, Harald Slatin, CandMed^*, Karin Janata, DrMed^*, Philip Eisenburger, DrMed^*, Alexander A. Bankier, DrMed, and Anton N. Laggner, DrMed^*

*University Clinic of Emergency Medicine and Radiology, University of Vienna, Austria

Address correspondence and reprint requests to Prof. Dr.Med. Fritz Sterz, Universitätsklinik für Notfallmedizin, Allgemeines Krankenhaus der Stadt Wien, Währinger Gürtel 18-20/6D, 1090 Wien, Austria. Address e-mail to Fritz.Sterz{at}AKH-Wien.ac.at

Important adverse effects of bystander cardiopulmonary resuscitation (CPR) are well known. We describe the number of nonmedical professional CPR-related complications in patients surviving cardiac arrest, as assessed by chest radiograph. Within 2 yr, all consecutive patients admitted to the department of emergency medicine at a university hospital who had a witnessed, nontraumatic, normothermic cardiac arrest were studied. Radiologically evaluated adverse effects were compared with Mann-Whitney U-tests between patients who received bystander basic life support (Bystander group) and patients who did not receive bystander basic life support before advanced life support was started (ALS group). For assessment of bystander CPR-associated complications, chest radiographs were used. Of 224 patients, 173 were eligible. The median age was 58 yr (interquartile range, 51–71 yr), and 126 patients (73%) were men. The incidence of adverse effects associated with assisted-ventilation maneuvers and external chest compressions did not differ significantly between groups (severe gastric insufflation, 17% vs 18% between the Bystander group [n = 59] and the ALS group [n = 96], respectively; suspicion of aspiration, 22% vs 17%, respectively; soft tissue emphysema, 2% vs 1%, respectively; and serial rib fractures, 8% vs 8%, respectively). CPR administered by nonmedical personnel did not increase the number of life support-related adverse effects in patients surviving cardiac arrest as assessed by means of chest radiograph on admission.

Implications: Complications related to cardiopulmonary bypass (CPR) are not increased whenCPR is administered by nonmedical personnel, as assessed by chest radiograph.These data may be valuable in motivating laypeople to perform basic lifesupport.

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999