The need to immobilise the cervical spine during cardiopulmonary resuscitation and electric shock administration in out-of-hospital cardiac arrest.
In cases of out-of hospital cardiac arrest (OHCA), falling to the ground can cause brain and neck trauma to the patient. We present a case of a man in his mid-60s who suffered from an OHCA resulting in a violent collapse. The patient received immediate cardiopulmonary resuscitation, but his spine was immobilised only after a large frontal haematoma was found. The resuscitation efforts resulted in return of spontaneous circulation and discharge from hospital. After this, doctors performed angioplasty, followed by a cardiopulmonary bypass. Later, CT scan examination reported a displaced and unstable fracture of the 6th vertebra without bone marrow involvement. The patient underwent a second operation. 40 days later, he was able to return home without sequela. This case shows the importance of analysing the circumstances of a fall, considering the possibility of two concomitant diagnoses and prioritising investigations and treatment.
Prehospital Emergency Department, Paris Fire Brigade, Paris, France.
Milene
M
Desroziers
Prehospital Emergency Department, Paris Fire Brigade, Paris, France.
Sophie
S
Mole
Prehospital Emergency Department, Paris Fire Brigade, Paris, France Sudden Death Expertise Center, Paris, France.
Daniel
http://orcid.org/0000-0002-6046-1234
D
Jost
Prehospital Emergency Department, Paris Fire Brigade, Paris, France.
Jean-Pierre
JP
Tourtier
D001368:Axis, Cervical Vertebra / Q000293:injuries*; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D004565:Electroconvulsive Therapy; D004632:Emergency Medical Services; D050723:Fractures, Bone; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D011482:Protective Devices