title: Cardiopulmonary resuscitation performed by bystanders does not increase adverse effects as assessed by chest radiography.
abstract: 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.
  
  
  CONCLUSIONS
  Complications related to cardiopulmonary bypass (CPR) are not increased when CPR is administered by nonmedical personnel, as assessed by chest radiograph. These data may be valuable in motivating lay people to perform basic life support.
authors: University Clinic of Emergency Medicine and Radiology, University of Vienna, Austria.
authors: E
authors: E
authors: Oschatz
authors: P
authors: P
authors: Wunderbaldinger
authors: F
authors: F
authors: Sterz
authors: M
authors: M
authors: Holzer
authors: J
authors: J
authors: Kofler
authors: H
authors: H
authors: Slatin
authors: K
authors: K
authors: Janata
authors: P
authors: P
authors: Eisenburger
authors: A A
authors: AA
authors: Bankier
authors: A N
authors: AN
authors: Laggner
mesh_terms: D000368:Aged; D001784:Blood Gas Analysis; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects*; D004632:Emergency Medical Services; D005260:Female; D006323:Heart Arrest / Q000000981:diagnostic imaging / Q000628:therapy*; D006336:Heart Massage / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D011446:Prospective Studies; D013902:Radiography, Thoracic