Regarding this issue, CPR guidelines are not very specific, and they merely recommend that compression be performed on the lower half of the breastbone. Hands position is another key factor in the effectiveness of CPR. Notwithstanding, the latest CPR guidelines 6 still recommend a compression depth between 5 and 6 cm for an average adult. A study based on a large sample of patients 5 found that higher survival rates were associated to a compression depth between 4.03 and 5.53 cm, with a survival peak at 4.56 cm. 4 The quality of CPR is highly related to an adequate chest compression depth. 3 CPR maneuvers, first described in the early 1960s, are mainly based on thoracic compressions. 1, 2 The survival chances of patients suffering CA rely on the application of cardiopulmonary resuscitation (CPR) maneuvers in the first few minutes. © 2017 Lippincott Williams & Wilkins, Inc.Cardiac arrest (CA) is one of the leading health problems that is responsible for a substantial number of deaths in industrialized countries. Therapeutic/care management study, level IV.
RP in the 65-year and older trauma population demonstrates a measurable decrease in mortality and respiratory complications, improves respiratory mechanics, and permits an accelerated return to functioning state. An equal percentage of patients in both groups entered rehabilitation facilities with average stay time of 18.5 and 28.53 days for the RP and NO groups, respectively. Four respiratory readmissions, two deaths, seven pneumonias, seven pleural-effusions, and 19 recurrent pneumothoraces were encountered in the NO group versus 0 in the RP group ( p < 0.001). Average intensive care unit days were 11.65 (6.45–16.85) and 8.29 (5.31–11.26) days in the NO and RP groups, respectively. RESULTSįrom 2003 to 2008, 50 NO patients were admitted with ages ranging 65 to 97 years, average ISS of 18.47 (14.28–22.66) versus ages ranging from 63 to 89 years, average ISS of 20.71 (15.7–25.73) for the RP group (n = 23). Comparisons were by χ 2 tests/Fisher's exact tests, Student's t tests and Wilcoxon rank sum tests. Independent variables analyzed included Injury Severity Score (ISS), number of rib fractures, mortalities, hospital days, intensive care unit days, pneumonia development, respiratory complications, readmission rates, need for and length of rehabilitation stay time.
Patients were followed prospectively with regard to lifestyle and functional satisfaction. With institutional review board approval, a retrospective review analyzed patients 65 years and older with rib fractures admitted from 2009 to 2015 receiving RP (RP group) (n = 23) compared to nonoperative, injury-matched controls admitted from 2003 to 2008 (NO group) (n = 50). We hypothesize that patients 65 years and older receiving rib plating (RP) have decreased mortality, complication rates, and an accelerated return to normal functional states when compared with controls.
The impact of rib fractures in the 65-year and older patient population has been well documented as have the mortality and pneumonia rates. Rib fractures after chest wall trauma are a common injury however, they carry a significant morbidity and mortality risk.
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