Department of Emergency Medicine, Kent Hospital, Warwick, Rhode Island.
J Emerg Med. 2022 Jul;63(1):e17-e21. doi: 10.1016/j.jemermed.2022.04.028. Epub 2022 Aug 6.
Although high-quality chest compressions are an essential, lifesaving component of cardiopulmonary resuscitation, injuries are common with both manual and mechanical chest compressions.
We discuss the case of a 77-year-old woman who sustained thoracic vertebral fractures after cardiopulmonary resuscitation involving both manual and mechanical chest compressions. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Routine post-cardiac arrest care should include evaluation for chest compression-related injury. If a patient has back pain, focal vertebral tenderness, or paraplegia after chest compressions, imaging to evaluate for vertebral fracture should be performed. If unable to assess for back pain or tenderness, consider imaging to evaluate for vertebral fracture in patients with kyphosis or osteopenia, as these patients are at higher risk for chest compression vertebral injury.
尽管高质量的胸外按压是心肺复苏术的一个重要的、救生的组成部分,但手动和机械胸外按压都会导致常见损伤。
我们讨论了一位 77 岁女性的病例,她在涉及手动和机械胸外按压的心肺复苏术后发生了胸椎骨折。
为什么急诊医生应该了解这一点?:常规心脏骤停后护理应包括评估与胸外按压相关的损伤。如果患者在胸外按压后出现背痛、局部脊柱压痛或截瘫,应进行影像学检查以评估是否存在椎体骨折。如果无法评估背痛或压痛,对于有脊柱后凸或骨质疏松症的患者,考虑进行影像学检查以评估椎体骨折,因为这些患者发生胸外按压椎体损伤的风险更高。