Mechanical asphyxia in conditions of cardiopulmonary resuscitation. A case report.
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Date
2023
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Ievads. Pētījumu rezultāti liecina, ka komplikāciju un traumu biežums pēc kardiopulmonālās reanimācijas svārstās no 21% līdz vairāk nekā 65%. Krūškurvja un ribu lūzumi ir visbiežāk ziņotās ārējās sirds masāžas komplikācijas. Turpmākajā gadījuma aprakstā aplūkots mehāniskās asfiksijas gadījums, ko izraisījusi kakla orgānu saspiešana un mēles kaula lūzums KPR apstākļos.
Gadījuma apraksts. Vīrietis atrada savu 40 gadus veco sievu guļam uz muguras bez dzīvības pazīmēm. Pēc vīra teiktā, abi bija lietojuši narkotiskās vielas. Vīrs sācis KPR - veicis elpināšanu un krūškurvja kompresijas. Tika izsaukta neatliekamā medicīniskā palīdzība, kas konstatēja sievietes nāvi. Autopsijā atklājās, ka nāvi izraisījusi mehāniskā asfiksija. KPR laikā kakls tika saspiests ar plaukstas pirkstiem, kas izraisīja dzīvībai bīstamu stāvokli - ārējās elpošanas traucējumus, kā rezultātā iestājās mehāniskā asfiksija un nāve. Par to liecina arī mēles kaula kreisā lielā raga nepilns lūzums ar asinsizplūdumu apkārtējos mīkstajos audos, kas varēja rasties neilgi pirms nāves iestāšanās, kā arī vispārasfiktiskās pazīmes. Līķa asinīs netika konstatētas narkotiskās vielas vai etilspirts.
Kopsavilkums. Ziņotais gadījums pierāda, ka nepareizi veikta kardiopulmonālā reanimācija var izraisīt kakla orgānu ārējo kompresiju, kas var rezultēties ar mehānisku asfiksiju un nāvi.
Secinājumi. Vairumā gadījumu mehānisku asfiksiju izraisa krūškurvja un/vai vēdera saspiešana, ķermeņa saspiešana ierobežotā telpā, kā arī žņaugšana un nosmakšana. Ir publicēti tikai daži mehāniskās asfiksijas gadījumi KPR apstākļos. Tā kā šādi gadījumi ir ļoti reti, nepieciešama rūpīga izmeklēšana, ko veic tiesu medicīnas eksperti, kā arī policija.
Introduction. Research results indicate that the rate of complications and injuries after cardiopulmonary resuscitation ranges from 21% to more than 65%. Thoracic and rib fractures are the most commonly reported complications of external cardiac massage or chest compressions. The following case history deals with a case of mechanical asphyxia due to a compression of the neck organs and a fracture of the hyoid bone in conditions of CPR. Case description. A husband found his 40-year-old wife lying on her back with no signs of life. According to the husband, both had used narcotic substances. The husband started CPR - performed breathing and chest compressions. Ambulance was called, and reported the death of a woman. The autopsy revealed that death was caused by mechanical asphyxia. During CPR, the neck was compressed with the fingers of the hand, which caused a life-threatening condition - external breathing disorders, which resulted in mechanical asphyxia and death. This is also evidenced by an incomplete fracture of the left big horn of the hyoid bone with hemorrhage in the soft tissues, which could have occurred shortly before death, and signs of general asphyxia. No narcotic substances or ethyl alcohol were detected in the blood of the corpse. Summary. Reported case demonstrates that improper cardiopulmonary resuscitation can lead to external compression of the neck organs, which can lead to mechanical asphyxia and death. Conclusions. In most cases, mechanical asphyxia is caused by compression of the chest and/or abdomen by a large weight, compression of the body in a confined space, as well as strangulation and suffocation. There are only a few published cases of mechanical asphyxia during CPR. Since such cases are very rare, a thorough investigation by forensic experts as well as the police is necessary.
Introduction. Research results indicate that the rate of complications and injuries after cardiopulmonary resuscitation ranges from 21% to more than 65%. Thoracic and rib fractures are the most commonly reported complications of external cardiac massage or chest compressions. The following case history deals with a case of mechanical asphyxia due to a compression of the neck organs and a fracture of the hyoid bone in conditions of CPR. Case description. A husband found his 40-year-old wife lying on her back with no signs of life. According to the husband, both had used narcotic substances. The husband started CPR - performed breathing and chest compressions. Ambulance was called, and reported the death of a woman. The autopsy revealed that death was caused by mechanical asphyxia. During CPR, the neck was compressed with the fingers of the hand, which caused a life-threatening condition - external breathing disorders, which resulted in mechanical asphyxia and death. This is also evidenced by an incomplete fracture of the left big horn of the hyoid bone with hemorrhage in the soft tissues, which could have occurred shortly before death, and signs of general asphyxia. No narcotic substances or ethyl alcohol were detected in the blood of the corpse. Summary. Reported case demonstrates that improper cardiopulmonary resuscitation can lead to external compression of the neck organs, which can lead to mechanical asphyxia and death. Conclusions. In most cases, mechanical asphyxia is caused by compression of the chest and/or abdomen by a large weight, compression of the body in a confined space, as well as strangulation and suffocation. There are only a few published cases of mechanical asphyxia during CPR. Since such cases are very rare, a thorough investigation by forensic experts as well as the police is necessary.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Autopsija, Mehāniska asfiksija, Kardiopulmonāla reanimācija (KPR), Mēles kaula lūzums, Autopsy, Mechanical asphyxia, Cardiopulmonary resuscitation (CPR), Fracture of the hyoid bone