title: Manual and automated cardiopulmonary resuscitation (CPR): a comparison of associated injury patterns.
abstract: The purpose of this study was to identify and compare patterns of trauma associated with AutoPulse(®) CPR and manual CPR. Finalized autopsy records from 175 decedents brought to the Harris County Institute of Forensic Sciences were reviewed, 87 received manual-only CPR, and 88 received AutoPulse(®) CPR (in combination with manual CPR as per standard protocol). The characteristic pattern observed in manual-only CPR use included a high frequency of anterior rib fractures, sternal fractures, and midline chest abrasions along the sternum. The characteristic pattern observed in AutoPulse(®) CPR use included a high frequency of posterior rib fractures, skin abrasions located along the anterolateral chest and shoulder, vertebral fractures, and a few cases of visceral injuries including liver lacerations, splenic lacerations, and hemoperitoneum. Knowledge of the AutoPulse(®) CPR injury pattern can help forensic pathologists differentiate therapeutic from inflicted injuries and therefore avoid an erroneous assessment of cause and manner of death.
authors.affiliation: Harris County Institute of Forensic Sciences, 1885 Old Spanish Trail, Houston, TX 77054, USA. deborrahpinto@gmail.com
authors.forename: Deborrah C
authors.initials: DC
authors.lastname: Pinto
authors.forename: Kathryn
authors.initials: K
authors.lastname: Haden-Pinneri
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Love
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D049429:Forensic Pathology; D050723:Fractures, Bone / Q000473:pathology; D006465:Hemoperitoneum / Q000473:pathology; D006801:Humans; D008099:Liver / Q000293:injuries / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012253:Rib Fractures / Q000473:pathology; D012867:Skin / Q000293:injuries / Q000473:pathology; D016103:Spinal Fractures / Q000473:pathology; D013154:Spleen / Q000293:injuries / Q000473:pathology; D013249:Sternum / Q000293:injuries / Q000473:pathology; D013909:Thorax; D055815:Young Adult
keywords: AutoPulse®; cardiopulmonary resuscitation; device-assisted cardiopulmonary resuscitation; forensic pathology; forensic science; trauma