Direct and Indirect Trauma in Resuscitation
Summary. To provide accident surgeons working under extreme conditions with reports on the results of their efforts, the complications of resuscitation measures in 30 atraumatic deaths in which a final fall was to be excluded were analyzed in a fundamental study. According to these results, there are two predilection sites for injuries, viz., the thorax and neck.
Thus, injuries to the bones of the thorax, which had occurred in 70% of all cases, were found regularly in rigid emphysematous thorax, and in 40% in elastic thorax after external cardiac massage. The typical secondary injuries are dealt with. Because of the great danger of a liver injury as observed in two cases, resuscitation measures using an extrathoracic cardiac massage machine appear to be problematic even if injuries to the bones of the thorax can be avoided in an elastic thorax.
Injury to the neck after intubation occurred nearly as often as injuries to the thorax after external cardiac massage. Local injuries were predominantly small hemorrhages and abrasions at the base of the tongue and in the tonsillar ring on the right. Hemorrhages in the neck musculature are likely to be attributed to the abutment injury, and the retropharyngeal hemorrhages to hyperextension.
The single organ most frequently injured overall was the cervical spine with an injury frequency of 66%. However, there was no indication, not even in a single case, that resuscitation measures had shortened the life of a patient.