Resuscitation Injuries

  • S. Leadbeatter


The concept of injury consequent upon attempts at resuscitation giving rise to difficulty in interpretation of injuries noted at post-mortem examination is not new, the possibility being alluded to in R v, Sidney Harry Fox in 1930 [1]. Many reviews of the types and range of injury encountered after — and attributed to — closed-chest cardiac massage [2] have appeared in the clinicopathological literature [3–16] but fewer have concentrated upon questions of medicolegal interpretation [17–24].


Cage Pneumonia Heparin Respiration Dehydration 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Jesse FT (editor). Trial of Sidney Harry Fox. Edinburgh: Hodge, 1934..Google Scholar
  2. 2.
    Kouwenhoven WB, Jude JR, Knickerbocker GG. Closed-chest cardiac massage. JAMA 1960;173:1064–7..PubMedGoogle Scholar
  3. 3.
    Baringer JR, Salzman EW, Jones WA, Friedlich AL. External cardiac massage. NEJM 1961;265:62–5..PubMedCrossRefGoogle Scholar
  4. 4.
    Clark DT. Complications following closed-chest cardiac massage. JAMA 1962;181:337–8..PubMedGoogle Scholar
  5. 5.
    Himmelhoch SR, Dekker A, Gazzaniga AB, Like AA. Closed-chest cardiac resuscitation - a prospective clinical and pathological study. NEJM 1964;270:118–22..PubMedCrossRefGoogle Scholar
  6. 6.
    Jude JR, Kouwenhoven WG, Knickerbocker GG. External cardiac resuscitation. Monogr Surg Sci 1964;1:59–117..PubMedGoogle Scholar
  7. 7.
    Silberberg B, Rachmaninoff N. Complications after external cardiac massage. Surg Gyn Obs 1964;119:6–10..Google Scholar
  8. 8.
    Moe N. Complications following resuscitation. Acta Med Scand 1967;182:773–9..Google Scholar
  9. 9.
    Patterson RH, Burns WA, Jannotta FS. Complications of external cardiac resuscitation: a retrospective review and survey of the literature. Med Ann Dis Columb 1974;43:389–94..Google Scholar
  10. 10.
    Atcheson SG, Fred HL. Complications of cardiac resuscitation. Am Heart J 1975;89:263–5..PubMedCrossRefGoogle Scholar
  11. 11.
    Bjork RJ, Snyder BD, Campion BC, Loewenson RB. Medical complications of cardiopulmonary arrest. Arch Int Med 1982;142:500–3..CrossRefGoogle Scholar
  12. 12.
    Powner DJ, Holcombe PA, Mello LA. Cardiopulmonary resuscitation-related injuries. Crit Care Med 1984;12:54–5..PubMedCrossRefGoogle Scholar
  13. 13.
    Bedell SE, Fulton E J. Unexpected findings and complications at autopsy after cardiopulmonary resuscitation (CPR). Arch Int Med 1986;146:1725–8.CrossRefGoogle Scholar
  14. 14.
    Krischer JP, Fine EG, Davis JH, Nagel EL. Complications of cardiac resuscitation. Chest 1987;92:287–91..PubMedCrossRefGoogle Scholar
  15. 15.
    Sommers MS. Potential for injury: trauma after cardiopulmonary resuscitation. Heart and Lung 1991;20:287–93..PubMedGoogle Scholar
  16. 16.
    Jones J, Fletter B. Complications after cardiopulmonary resuscitation. Am J Emerg Med 1994;12:687–8..PubMedCrossRefGoogle Scholar
  17. 17.
    Paaske F, Hart Hansen JP, Koudahl G, Olsen J. Complications of closed-chest cardiac massage in a forensic autopsy material. Dan Med Bull 1968;15:225–30..Google Scholar
  18. 18.
    Härm T, Rajs J. Face and neck injuries due to resuscitation versus throttling. Forensic Sci Int 1983;23:109–16..PubMedCrossRefGoogle Scholar
  19. 19.
    Feldman KW, Brewer DK. Child abuse, cardiopulmonary resuscitation and rib fractures. Pediatrics 1984;73:339–42..PubMedGoogle Scholar
  20. 20.
    Hood I, Ryan D, Spitz WU. Resuscitation and petechiae. Am J Forensic Med Pathol 1988;9:35–7..PubMedCrossRefGoogle Scholar
  21. 21.
    Leadbeatter S, Knight B. Resuscitation artefact. Med Sci Law 1988;28:200–4..PubMedGoogle Scholar
  22. 22.
    Sperry K. Anterior thoracic wall trauma in elderly homicide victims - the “CPR defense”. Am J Forensic Med Pathol 1990;11:50–5..PubMedCrossRefGoogle Scholar
  23. 23.
    Bush CM, Jones JS, Cohle SD, Johnson H. Pediatric injuries from cardiopulmonary resuscitation. Ann Emerg Med 1996;28:40–4..PubMedCrossRefGoogle Scholar
  24. 24.
    Raven KP, Reay DT, Harruff RC. Artifactual injuries of the larynx produced by resuscitative intubation. Am J Forensic Med Pathol 1999;20:31–6..PubMedCrossRefGoogle Scholar
  25. 25.
    Heimlich HJ. Pop goes the cafe coronary. Emerg Med 1974;6:154–5..Google Scholar
  26. 26.
    Coletti RH, Kaskel PS, Cohen SR, Bregman D. Abdominal counterpulsation: a new concept in circulatory assistance. Trans Am Soc Artif Intern Organs 1982;28:563–6..PubMedGoogle Scholar
  27. 27.
    Bellegie JJ, Seldon TH, Judd ES, Jr. Cardiac massage for cardiac arrest during surgery. Proc Mayo Clin 1952;27:305–9..Google Scholar
  28. 28.
    Taylor GJ, Rubin R, Tucker M, Greene HL, Rudikoff MT, Weisfeldt ML. External cardiac compression - a randomized comparison of mechanical and manual techniques. JAMA 1978;240:644–6..PubMedCrossRefGoogle Scholar
  29. 29.
    Cohen TJ, Tucker KJ, Lurie KG, Redberg RF, Dutton JP, Dwyer KA et al. Active compression-decompression — a new method of cardiopulmonary resuscitation. JAMA 1992, 267: 2916–23 .PubMedCrossRefGoogle Scholar
  30. 30.
    Kouwenhoven WB, Milnor WR, Knickerbocker GG, Chestnut WR. Closed defibrillation of heart. Surgery 1957;42:550–61..PubMedGoogle Scholar
  31. 31.
    Farley M . The esophageal oturator airway. Resp Therapy 1973;3:95.Google Scholar
  32. 32.
    Haugeberg G, Bonarjee V, Dickstein K. Fatal intrathoracic haemorrhage after cardiopulmonary resuscitation and treatment with streptokinase and heparin. Br Heart J 1989;62:157–8..PubMedCrossRefGoogle Scholar
  33. 33.
    Leadbeatter S, Weston C, Hulewics B. Sudden death in the community: the incidence and nature of injuries sustained in failed resuscitation. In: Somogyi E, Sotonyi P (Editors). Sudden cardiac death. Budapest: Semmelweis Kiado, 1994;154–8..Google Scholar
  34. 34.
    Gregersen M, Vesterby A. Iatrogenic fractures of the hyoid bone and the thyroid cartilage — a case report. Forensic Sci Int 1981;17:41–3..PubMedCrossRefGoogle Scholar
  35. 35.
    Heath K, Palmer M, Fletcher S. Fracture of the cricoid cartilage after Sellick’s manoeuvre. Br J Anaesth 1996;76:877–8..PubMedGoogle Scholar
  36. 36.
    Rao VJ, Wetli CV. The forensic significance of conjunctival petechiae. Am J Forensic Med Pathol 1988;9:32–4.PubMedCrossRefGoogle Scholar
  37. 37.
    Henriksen H. Rib fractures following external cardiac massage. Acta Anaesth Scand 1967;11:55–64.CrossRefGoogle Scholar
  38. 38.
    Enarson DA, Didier EP, Gracey DR. Flail chest as a complication of cardiopulmonary resuscitation. Heart & Lung 1977;6:1020–2.Google Scholar
  39. 39.
    Mensah GA, Gold JP, Schreiber T, Isom OW. Acute purulent mediastinitis and sternal osteomyelitis after closed chest cardiopulmonary resuscitation — a case report and review of the literature. Ann Thorac Surg 1988;46:353–5.PubMedCrossRefGoogle Scholar
  40. 40.
    Rabl W, Baubin M, Broinger G, Scheithauer R. Serious complication from active compression-decomposition cardiopulmonary resuscitation. Int J Legal Med 1996;109:84–9.PubMedCrossRefGoogle Scholar
  41. 41.
    Okei BB. Vertebral fractured from cardioversion shock. JAMA 1968:203:131.CrossRefGoogle Scholar
  42. 42.
    Jeong Y-G, Caccamo LP. Cardiac resuscitation and vertebral fracture. JAMA 1975;234:1223..PubMedCrossRefGoogle Scholar
  43. 43.
    Azuma SS, Mashiyama ET, Goldsmith CI, Abbasi AS. Chest compression-induced vertebral fractures. Chest 1986;89:154–5.PubMedCrossRefGoogle Scholar
  44. 44.
    Goldberg RM, Rowan L, Anderson RE. Thoracic vertebral fracture as a complication of cardiopulmonary resuscitation. J Emerg Med 1988;6:177–8.PubMedCrossRefGoogle Scholar
  45. 45.
    Cho SY,Anthony C. Pulmonary embolism by hepatic tissue after external cardiac massage. JAMA 1976;236:140–1.PubMedCrossRefGoogle Scholar
  46. 46.
    Kaplan BM, Knott AP, Jr. Closed-chest cardiac massage for circulatory arrest. Arch Int Med 1964;114:5–12.Google Scholar
  47. 47.
    Peddie GH, Creech O, Jr, Halpert B. Structural changes in the heart resulting from cardiac massage. Surgery 1965;40:481–7.Google Scholar
  48. 48.
    Adelson L. A clinicopathologic study of the anatomic changes in the heart resulting from cardiac massage. Surg Gyn Obs 1957;104:513–23.Google Scholar
  49. 49.
    Stephenson HE, Reid LC, Hinton JW. Pitfalls, precausions, and complications in cardiac resucitation. Arch Surg 1954;69:37–53.Google Scholar
  50. 50.
    Wilcox BR. Disruption of a mitral-valve prosthesis — a complication associated with closed-chest cardiac massage. JAMA 1965;194:205–6. CrossRefGoogle Scholar
  51. 51.
    Burnside J, Daggett WM, Austen WG. Coronary artery rupture by a mitral valve prosthesis after closed chest massage. Ann Thorac Surg 1970;9:267–71 PubMedCrossRefGoogle Scholar
  52. 52.
    Thomas TV. Cardiac resuscitation in patients with prosthetic cardiac valves. Chest 1972;62:652–3 PubMedCrossRefGoogle Scholar
  53. 53.
    Wild LM, Lajos TZ, Lee AB, Jr, Wright J. Left ventricular laceration due to stented prosthesis. Chest 1980;77:216–7. PubMedCrossRefGoogle Scholar
  54. 54.
    Wolfe WG, Dudley AW, Jr, Wallace AG. A pathological study of unsuccessful cardiac resuscitation. Arch Surg 1968;96:123–6. PubMedGoogle Scholar
  55. 55.
    Agdal N, Jørgensen TG. Penetrating laceration of the pericardium and myocardium and myocardial rupture following closed-chest cardiac massage. Acta Med Scand 1973;194:477–9. PubMedCrossRefGoogle Scholar
  56. 56.
    Biggart JD, McClure J. Right atrial laceration. Br Heart J 1975;37:652–5. PubMedCrossRefGoogle Scholar
  57. 57.
    Atcheson SG, Petersen GV, Fred HL. I11-effects of cardiac resuscitation: report of two unusual cases. Chest 1975;67:615–6. PubMedCrossRefGoogle Scholar
  58. 58.
    Baldwin JJ, Edwards JE. Rupture of right ventricle complicating closed chest cardiac massage. Circulation 1976;53:562–4. PubMedGoogle Scholar
  59. 59.
    Sethi GK, Scott SM, Takaro T. Complications of external cardiac massage: report of a case of laceration of the right ventricular outflow tract. J Cardiovasc Surg 1977;18:187–90. Google Scholar
  60. 60.
    Gerry JL, Jr, Bulkley BH, Hutchins GM. Rupture of the papillary muscle of the tricuspid valve: a complication of cardiopulmonary resuscitation and a rare cause of tricuspid insufficiency. Am J Cardiol 1977;40:825–8. PubMedCrossRefGoogle Scholar
  61. 61.
    Bodily K, Fischer RP. Aortic rupture and right ventricular rupture induced by closed chest cardiac massage. Minn Med 1979;62:225–7. PubMedGoogle Scholar
  62. 62.
    Engelman RM, Rousou JA, Schweiger M. Traumatic ventricular septal defect following closed chest massage: a new approach to closure. Ann Thorac Surg 1984;38:529–32. PubMedCrossRefGoogle Scholar
  63. 63.
    Noffsinger AE, Blisard KS, Balko MG. Cardiac laceration and pericardial tamponade due to cardiopulmonary resuscitation after myocardial infarction. J Forensic Sci 1991;36:1760–4. PubMedGoogle Scholar
  64. 64.
    Fosse E, Lindbergh H. Left ventricular rupture following external chest compression. Acta Anaesth Scand 1996;40:502–4. PubMedCrossRefGoogle Scholar
  65. 65.
    Klintschar M, Darok M, Radner H. Massive injury to the heart after attempted active compression- decompression cardiopulmonary resuscitation. Int J Legal Med 1998;111:93–6. PubMedCrossRefGoogle Scholar
  66. 66.
    Yamada EY, Fukunaga FH. Cardiopulmonary complications of external cardiac massage. Hawaii Med J 1969;29:114–7. PubMedGoogle Scholar
  67. 67.
    Baker PB, Keyhani-Rofagha S, Graham RL, Sharma HM. Dissecting hematoma (aneurysm) of coronary arteries. Am J Med 1986;80:317–9. PubMedCrossRefGoogle Scholar
  68. 68.
    Saphir R. External cardiac massage: prospective analysis of 123 cases and review of the literature. Medicine 1968;47:73–87. PubMedCrossRefGoogle Scholar
  69. 69.
    Davison R, Barresi V, Parker M, Meyers SN, Talano JV. Intracardiac injections during cardiopulmonary resuscitation — a low-risk procedure. JAMA 1980;244:1110–11. PubMedCrossRefGoogle Scholar
  70. 70.
    Bahler RC, Carson P, White RJ. Cardiac tamponade following external cardiac massage. Am Heart J 1968;76:850–1. PubMedCrossRefGoogle Scholar
  71. 71.
    Jude J, Kouwenhoven WB, Knickerbocker GG. Cardiac arrest. JAMA 1961;178:1063–70..PubMedGoogle Scholar
  72. 72.
    Nelson DA, Ashley PF. Rupture of the aorta during closed-chest cardiac massage. JAMA 1965;193:681–3..PubMedGoogle Scholar
  73. 73.
    Dorsa FB, Tuniek PA, Culliford A, Kronzon I. Pseudoaneurysm of the thoracic aorta due to cardiopulmonary resuscitation: diagnosis by transesophageal echocardiography. Am Heart J 1992;123:1398–1400..PubMedCrossRefGoogle Scholar
  74. 74.
    Morgan RR. Laceration of the liver from closed-chest cardiac massage. NEJM 1961;265:82–3..PubMedCrossRefGoogle Scholar
  75. 75.
    Bynum WR, Connell RM, Hawk WA. Causes of death after external cardiac massage: analysis of observations on fifty consecutive autopsies. Cleveland Clin Quart 1963;30:147–51..PubMedGoogle Scholar
  76. 76.
    Johannson BW. External cardiac massage. Acta Med Scand 1964;176:319–27..CrossRefGoogle Scholar
  77. 77.
    Lawrence RM, Haley EM, Gillies AJ. Closed-chest cardiopulmonary resuscitation: results and criteria for application. NY State J Med 1964;64:2523–32..Google Scholar
  78. 78.
    Roser LA. Cardiopulmonary resuscitation experience in a general hospital: review of 116 consecutive resuscitative attempts during a 2 1/2-year period. Arch Surg 1967;95:658–63..PubMedGoogle Scholar
  79. 79.
    Adler SN, Klein RA, Pellecchia C, Lyon DT. Massive hepatic hemorrhage associated with cardiopul¬monary resuscitation. Arch Int Med 1983;143:813–4..CrossRefGoogle Scholar
  80. 80.
    Lau G. A case of sudden maternal death associated with resuscitative liver injury. Forensic Sci Int 1994;67:127–32..PubMedCrossRefGoogle Scholar
  81. 81.
    Druwe PM, Cools FJ, De Raedt HJ, Bossaert LL. Liver rupture after cardiopulmonary resuscitation in a patient receiving thrombolytic therapy. Resuscitation 1996;32:213–6.PubMedCrossRefGoogle Scholar
  82. 82.
    Klassen GA, Broadhurst C, Peretz DI, Johnson AL. Cardiac resuscitation in 126 medical patients using external cardiac massage. Lancet 1963;1:1290–2..PubMedCrossRefGoogle Scholar
  83. 83.
    Minuck M. Organization and experiences of a cardiac resuscitation service. Can Anaesth Soc J 1966;13:52–61..PubMedCrossRefGoogle Scholar
  84. 84.
    Anon. Discussion on complications of cardiopulmonary resuscitation. Acta Anaesth Scand 1968; Supp 29–32:319–26..Google Scholar
  85. 85.
    Jeresaty RM, Godar TJ, Liss JP. External cardiac resuscitation in a community hospital: a three-year experience. Arch Int Med 1969;124: 588–92..CrossRefGoogle Scholar
  86. 86.
    Lundberg GD, Mattei IR, Davis CJ, Nelson DE. Hemorrhage from gastroesophageal lacerations following closed-chest cardiac massage. JAMA 1967;202:123–6..CrossRefGoogle Scholar
  87. 87.
    Anthony PP, Tattersfìeld AE. Gastric mucosal lacerations after cardiac resuscitation. Br Heart J 1969;31:72–5..PubMedCrossRefGoogle Scholar
  88. 88.
    Aguilar JC. Fatal gastric hemorrhage: a complication of cardiorespiratory resuscitation. J Trauma 1981;21:573–5..PubMedCrossRefGoogle Scholar
  89. 89.
    McDonnell PJ, Hutchins GM, Hruban RH, Brown CG. Hemorrhage from gastric mucosal tears complicating cardiopulmonary resuscitation. Ann Emerg Med 1984;13:230–3..PubMedCrossRefGoogle Scholar
  90. 90.
    Register SD, Downs JB, Tabeling BB. Gastric mucosal lacerations: a complication of cardiopulmonary resuscitation. Anesthesiology 1985;62:513–4..PubMedCrossRefGoogle Scholar
  91. 91.
    Hulewicz B. Gastric trauma following cardiopulmonary resuscitation. Med Sci Law 1990;30:149–52..PubMedGoogle Scholar
  92. 92.
    Norfleet RG, Smith GH. Mallory-Weiss syndrome after cardiopulmonary resuscitation. J Clin Gastroenterol 1990;12:569–72..PubMedCrossRefGoogle Scholar
  93. 93.
    Demos NJ, Poticha SM. Gastric rupture occurring during external cardiac resuscitation. Surgery 1964;55:364–6..PubMedGoogle Scholar
  94. 94.
    Valtonen EJ, Hakola N. Rupture of the stomach during mouth-to-mouth resuscitation. Acta Chir Scand 1964;127:427–31..PubMedGoogle Scholar
  95. 95.
    Cassebaum WH, Carberry DM, Stefko P. Rupture of the stomach from mouth-to-mouth resuscitation. J Trauma 1974;14:811–4..PubMedCrossRefGoogle Scholar
  96. 96.
    Solowiejczyk M, Koven E, Wapnick S, Mandelbaum U. Rupture of the stomach following mouth-to- mouth resuscitation. Postgrad Med J 1974;50:769–72..PubMedCrossRefGoogle Scholar
  97. 97.
    Darke SG, Bloomfield E. Case of complete gastric rupture complicating resuscitation. BMJ 1975;3:414–5..PubMedCrossRefGoogle Scholar
  98. 98.
    Matikainen M. Rupture of the stomach: a rare complication of resuscitation. Acta Chir Scand 1978;144:61..PubMedGoogle Scholar
  99. 99.
    Linch D, McDonald A, McNicol L. Tension pneumoperitoneum complicating cardiac resuscitation. Intensive Care Med 1979;5:93–4..CrossRefGoogle Scholar
  100. 100.
    Mills SA, Paulson D, Scott SM, Sethi G. Tension pneumoperitoneum and gastric rupture following cardiopulmonary resuscitation. Ann Emerg Med 1983;12:94–5..PubMedCrossRefGoogle Scholar
  101. 101.
    Shemesh E, Dreznik Z, Schecter P et al. Rupture of stomach due to external cardiac resuscitation. Isr J Med Sci 1983;19:853–4..PubMedGoogle Scholar
  102. 102.
    Engelstein D, Stamler B. Gastric rupture complicating mouth-to-mouth resuscitation. Isr J Med Sci 1984;20:68–70..PubMedGoogle Scholar
  103. 103.
    Krause S, Donen N. Gastric rupture during cardiopulmonary resuscitation. Can Anaesth Soc J 1984;31:319–32..PubMedCrossRefGoogle Scholar
  104. 104.
    Schein M, Falkov A, Decker GAG. Gastric rupture due to external cardiac massage following gastroscopy. Gastroint Endose 1985;31:291–2..CrossRefGoogle Scholar
  105. 105.
    Woods SDS, Hutchinson G, Johnson WR, Masterton JP. Gastric rupture following cardiopulmonary resuscitation. Aust NZ J Surg 1986;56:733–5..CrossRefGoogle Scholar
  106. 106.
    Vinen JD, Gaudry PL. Pneumoperitoneum complicating cardiopulmonary resuscitation. Anaesth Intens Care 1986;14:193–6..Google Scholar
  107. 107.
    Varekamp AP, Liem BK. Gastric rupture: a rare complication of resuscitation. Netherlands J Surg 1987;39:198..Google Scholar
  108. 108.
    Low LL, Ripple GR, Bruderer BP, Harrington GR. Non-operative management of gastric perforation secondary to cardiopulmonary resuscitation. Intensive Care Med 1994;20:442–3..PubMedCrossRefGoogle Scholar
  109. 109.
    Liu N, Boyle K, Bertrand C, Bonnet F. Stomach rupture during CPR. Ann Emerg Med 1996; 27:105–6..PubMedCrossRefGoogle Scholar
  110. 110.
    Reiger J, Eritscher C, Laubreiter K, Trattnig J, Sterz F, Grimm G. Gastric rupture - an uncommon complication after successful cardiopulmonary resuscitation: report of two cases. Resuscitation 1997;35:175–8..PubMedCrossRefGoogle Scholar
  111. 111.
    Strear CM, Jarnagin WR, Schecter W, Mackersie RC, Hickey MS. Gastric rupture and tension pneumoperitoneum complicating cardiopulmonary resuscitation: case report J Trauma 1998;44:930–2..Google Scholar
  112. 112.
    Oh CM, Hewitt PM. Gastric rupture due to cardiopulmonary resuscitation. Injury 1998;29:399–400..PubMedCrossRefGoogle Scholar
  113. 113.
    Lion-Cachet J. Gastric fundal mucosal tears. Br J Surg 1963;50:985–6..PubMedCrossRefGoogle Scholar
  114. 114.
    Berlinerblau R, Marmolejos F, Bykofsky MM. Delayed rupture of the spleen after cardiac massage. JAMA 1980;243:364–5..PubMedCrossRefGoogle Scholar
  115. 115.
    Bernard SA, Jones BMacC, Scott WJ. Intra-abdominal complications following prolonged cardiopulmonary resuscitation. Aust NZ J Surg 1993;63:312–4.CrossRefGoogle Scholar
  116. 116.
    Stallard N, Findlay G, Smithies M. Splenic rupture following cardiopulmonary resuscitation- Resuscitation 1997;35:171–3..Google Scholar
  117. 117.
    Razaboni RM, Brathwaite CEM, Dwyer WA, Jr. Ruptured jejunum following Heimlich maneuver. J EmergMed 1986;4:95–8..PubMedCrossRefGoogle Scholar
  118. 118.
    Valero V. Mesenteric laceration complicating a Heimlich maneuver. Ann Emerg Med 1986;15:105–6..PubMedCrossRefGoogle Scholar
  119. 119.
    Heimlich HJ. The Heimlich maneuver: where it stands today. Emerg Med 1978;10:89–101..Google Scholar
  120. 120.
    Palmer ED. The Heimlich maneuver misused. Curr Prescribing 1979;5:45–9..Google Scholar
  121. 121.
    Entel RJ, Hakki A-H. Bone scan after the Heimlich maneuver. Clin Nuclear Med 1996;21:251..CrossRefGoogle Scholar
  122. 122.
    Agia GA, Hurst DJ. Pneumomediastinum following the Heimlich maneuver. JACEP 1979;8:473–5..PubMedGoogle Scholar
  123. 123.
    Haynes DE, Haynes BE, Yong YV. Esophageal rupture complicating Heimlich maneuver. Am J EmergMed 1984;2:507–9..CrossRefGoogle Scholar
  124. 124.
    Meredith MJ, Liebowitz R. Rupture of the esophagus caused by the Heimlich maneuver. Ann EmergMed 1986;15:106–7..CrossRefGoogle Scholar
  125. 125.
    Chapman JH, Menapace FJ, Howell RR. Ruptured aortic valve cusp: a complication of the Heimlich maneuver. Ann Emerg Med 1983;12:446–8..PubMedCrossRefGoogle Scholar
  126. 126.
    Visintine RE, Baick CH. Ruptured stomach after Heimlich maneuver. JAMA 1975;234:415..PubMedCrossRefGoogle Scholar
  127. 127.
    Croom DW. Rupture of the stomach after attempted Heimlich maneuver. JAMA 1983;250:2602–3..PubMedCrossRefGoogle Scholar
  128. 128.
    Cowan M, Bardole J, Dlesk A. Perforated stomach following the Heimlich maneuver. Am J Emerg Med 1987;5:121–2..PubMedCrossRefGoogle Scholar
  129. 129.
    Dupre MW, Silva E, Brotman S. Traumatic rupture of the stomach secondary to Heimlich maneu¬ver. Am J Emerg Med 1993;11:611–2..PubMedCrossRefGoogle Scholar
  130. 130.
    Bintz M, Cogbill TH. Gastric rupture after the Heimlich maneuver. J Trauma 1996;40:159–60..PubMedCrossRefGoogle Scholar
  131. 131.
    Majumdar A, Sedman PC. Gastric rupture secondary to successful Heimlich manoeuvre. Postgrad Med J 1998; 74:609–10..PubMedCrossRefGoogle Scholar
  132. 132.
    Roehm EF, Twiest MW, Williams RC, Jr. Abdominal aortic thrombosis in association with an attempted Heimlich maneuver. JAMA 1983;249:1186–7..PubMedCrossRefGoogle Scholar
  133. 133.
    Feldman T, Mallon SM, Bolooki H, Trohman RG, Guzman P, Myerburg RJ. Fatal acute aortic regur¬gitation in a person performing the Heimlich maneuver. NEJM 1986;315:1613..PubMedCrossRefGoogle Scholar
  134. 134.
    Young CD. Esophageal perforation associated with combined use of the Thumper resuscitator and esophageal airway. South Med J 1983;76:332–4..PubMedCrossRefGoogle Scholar
  135. 135.
    Strate RG, Fischer RP. Midesophageal perforations by esophageal obturator airways. J Trauma 1976;16:503–9..PubMedCrossRefGoogle Scholar
  136. 136.
    Cohle SD, Hawley DA, Berg KK, Kiesel EL, Pless JE. Homicidal cardiac lacerations in children. J Forensic Sci 1995;40:212–8..PubMedGoogle Scholar
  137. 137.
    Reardon MJ, Gross DM, Vallone AM, Weiland AP, Walker WE. Atrial rupture in a child from cardiac massage by his parent. Ann Thorac Surg 1987;43:557–8..PubMedCrossRefGoogle Scholar
  138. 138.
    Guevara U, Greenberg H, Hertzog AJ. Traumatic damage to the heart from cardiac massage. Surgery 1962;51:211–5..Google Scholar
  139. 139.
    Spevak MR, Kleinman PK, Belanger PL, Primack C, Richmond JM. Cardiopulmonary resuscitation and rib fractures in infants: a post mortem radiologic-pathologic study. JAMA 1994;272:617–8..PubMedCrossRefGoogle Scholar
  140. 140.
    Betz P, Liebhardt E. Rib fractures in children - resuscitation or child abuse? Int J Legal Med 1994;106:215–8..PubMedCrossRefGoogle Scholar
  141. 141.
    Keeling JW. Sudden unexpected infant death. In: Berry CL (editor). Paediatric pathology, 3rd edition. London: Springer-Verlag, 1996,910.Google Scholar
  142. 142.
    Thaler MM, Krause VW. Serious trauma in children after external cardiac massage. NEJM 1962;267:500–1..PubMedCrossRefGoogle Scholar
  143. 143.
    Waldman PJ, Walters BL, Grunau CFV. Pancreatic injury associated with interposed abdominal compressions in pediatric cardiopulmonary resuscitation. Am J Emerg Med 1984;2:510–2..PubMedCrossRefGoogle Scholar
  144. 144.
    Thaler MM, Stobie GHC. An improved technic of external cardiac compression in infants and young children. NEJM 1963;269:606–10..PubMedCrossRefGoogle Scholar
  145. 145.
    Custer JR, Polley TZ, Jr, Moler F. Gastric perforation following cardiopulmonary resuscitation in a child: report of a case and review of the literature. Pediatric Emerg Care 1987;3:24–7..CrossRefGoogle Scholar
  146. 146.
    Elders MJ, Hughes ER. Rupture of the stomach: clinical and experimental study. Journal-Lancet 1966;86:104–8..PubMedGoogle Scholar
  147. 147.
    Berg MD, Idris AH, Berg RA. Severe ventilatory compromise due to gastric distension during pediatric cardiopulmonary resuscitation. Resuscitation 1998;36:71–3..PubMedCrossRefGoogle Scholar
  148. 148.
    Galvis AG, Kelley CF. Hypopharynx perforation during infant’s resuscitation. JAMA 1979;242:1526–7..PubMedCrossRefGoogle Scholar
  149. 149.
    Kaplan JA, Fossum RM. Patterns of facial resuscitation injury in infancy Am J Forensic Med Pathol 1994;15:187–91..Google Scholar
  150. 150.
    Nowitz A, Lewer BMF, Galletly DC. An interesting complication of the Heimlich manoeuvre. Resuscitation 1998;39:129–31..PubMedCrossRefGoogle Scholar
  151. 151.
    Bacon CJ, Sayer GC, Howe J. Extensive retinal haemorrhages in infancy - an innocent cause. BMJ 1978;1:281..PubMedCrossRefGoogle Scholar
  152. 152.
    Kirschner RH, Stein RJ. The mistaken diagnosis of child abuse: a form of medical abuse? Am J Dis Child 1985;139:873–5..PubMedGoogle Scholar
  153. 153.
    Greenwald M J, Weiss A, Oesterle CS, Friendly DS. Traumatic retinoschisis in battered babies. Ophthalmology 1986;93:618–25..Google Scholar
  154. 154.
    Weedn VW, Mansour AM, Nichols MM. Retinal hemorrhage in an infant after cardiopulmonary resuscitation. Am J Forensic Med Pathol 1990;11:79–82..PubMedCrossRefGoogle Scholar
  155. 155.
    Riffenburgh RS, Sathyavagiswaran L. Ocular findings at autopsy of child abuse victims. Ophthalmology 1991;98:1519–24..PubMedGoogle Scholar
  156. 156.
    Kramer K, Goldstein B. Retinal hemorrhages following cardiopulmonary resuscitation. Clin Pediatrics 1993;32:366–8..CrossRefGoogle Scholar
  157. 157.
    Kanter RK. Retinal hemorrhage after cardiopulmonary resuscitation or child abuse. J Pediatrics 1986;108:430–2..CrossRefGoogle Scholar
  158. 158.
    Goetting MG, Sowa B. Retinal hemorrhage after cardiopulmonary resuscitation in children: an etiologic reevaluation. Pediatrics 1990;85:585–8..PubMedGoogle Scholar
  159. 159.
    Gilliland MGF, Luckenbach MW. Are retinal hemorrhages found after resuscitation attempts? A study of the eyes of 169 children. Am J Forensic Med Pathol 1993;14:187–92..PubMedCrossRefGoogle Scholar
  160. 160.
    Odom A, Christ E, Kerr N, Byrd K, Cochran J, Bugnitz M et al Prevalence of retinal hemorrhages in pediatric patients after in-hospital cardiopulmonary resuscitation:a prospective study. Pediatrics 1997;99:
  161. 161.
    Botash AS, Blatt S, Meguid V. Child abuse and sudden infant death syndrome. Curr Opin Pediatrics 1998;10:217–23..CrossRefGoogle Scholar
  162. 162.
    Ophthalmology Child Abuse Working Party. Child abuse and the eye. Eye 1999;13:3–10..CrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2001

Authors and Affiliations

  • S. Leadbeatter

There are no affiliations available

Personalised recommendations