Abstract
An: 2017, Nr.1, Articol Nr. 15
Title: 

FORENSIC SIGNIFICANCE OF LESIONS INDUCED BY CARDIOPULMONARY RESUSCITATION

Authors: 

      Sofia David, A. Knieling, Diana Bulgaru-Iliescu - University of Medicine and Pharmacy “Grigore T. Popa”, Iasi, Romania, Discipline of Forensic Medicine; Institute of Forensic Medicine, Iasi, Romania
      Carleta Teodorescu, L. Teodorescu, R. Dospinescu - Institute of Forensic Medicine, Iasi, Romania
      FORENSIC SIGNIFICANCE OF LESIONS INDUCED BY CARDIOPULMONARY RESUSCITATION (Abstract): Cardiopulmonary resuscitation (CPR) is a lifesaving emergency procedure generating various injuries. At necropsy examination, lesions produced by CPR maneuvers are regularly encountered, unrelated to the primary death cause. The aim of the current study is to examine traumatic injuries observed at forensic necropsy after CPR and to make the differential diagnosis with those induced by violent acts or accidents. The authors performed a retrospective study at the Institute of Forensic Medicine from Iasi, Romania on 49 cases (32 males, 17 females) that benefited from CPR manoeuvres prior to death. Mean age was 47.3 years, 24 cases (48.98%) presented cardiac arrest secondary to trauma and 41 (83.67%) in an extra-hospital environment. CPR duration reported in 21 cases (42.86%) registered a mean value of 42 minutes. Additional gestures like vein puncture were reported in 25 cases (51.02%) and surgical interventions in 5 cases (10.20%). All intra-thoracic structures can be injured directly or indirectly by chest compressions. Rib fractures are among the most common complications associated with CPR and found in one third of cases. Petechiae on the surface of the heart are observed mostly on the posterior surface. Perivascular haemorrhagic infiltrations can also be noticed and are poorly described in the literature. Intra-abdominal organs are less often the site of complications secondary to resuscitation. In conclusion, injuries produced during CPR may be responsible for important artefacts impeding the understanding of traumatic lesions observed during necropsy and related to the primary death cause. A thorough knowledge of possible aspects is mandatory to the differential diagnosis with other traumatic lesions.
Key words: CARDIOPULMONARY RESUSCITATION, FORENSIC NECROPSY, TRAUMATIC LESIONS, DIFFERENTIAL DIAGNOSIS
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