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Case Study: Resuscitation of an Elderly Cardiac Arrest Victim with Spinal Trauma

Case Study: Resuscitation of an Elderly Cardiac Arrest Victim with Spinal Trauma. and Use of a Mechanical Chest Compression Device. Case Presentation. Medical Cardiac Arrest?. Traumatic Arrest?. Mechanical Chest Compression. ► LUCAS Chest Compression System. Indications

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Case Study: Resuscitation of an Elderly Cardiac Arrest Victim with Spinal Trauma

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  1. Case Study:Resuscitation of an Elderly Cardiac Arrest Victim with Spinal Trauma and Use of a Mechanical Chest Compression Device

  2. Case Presentation

  3. Medical Cardiac Arrest? Traumatic Arrest?

  4. Mechanical Chest Compression

  5. ► LUCAS Chest Compression System Indications • Adult patients with medical cardiac arrest • Cases where manual chest compression would be used Contraindications Do NOT use LUCAS Chest Compression System in the following cases: • Adult patient too small: The pad within the suction cup does not touch patient’s chest when it is lowered as far as possible • Adult patient too large: The support legs of the LUCAS cannot be locked to the back plate without compressing the patient. • Patient < 18 years old • Traumatic arrest • Pregnant patients

  6. Case Presentation - continued • Manual CPR turned over to First Responders • Cardiac monitor – PEA @ rate of 56 • Spinal Immobilization • LUCAS applied • IV/Meds/ET (blood in the airway) • Transport • Enroute – ROSC – NSR with PVCs >6/min

  7. Case Presentation – continued • Transfer to ED personnel • Strong radial pulse – rate of 70 • BP 100 systolic • Apneic – ventilations by EMS personnel • Pulse Oximetry with O2 – 86%

  8. Emergency Department Findings • Patient nonresponsive • Placed on ventilator • Hematoma over left eye, scalp laceration, abrasion left knee • CT demonstrated a fracture through the odontoid and a fracture/disruption of the posterior ring of C1

  9. Case Presentation – conclusion • Transfer to Trauma Center • High Cervical Spine Fracture – Type II C2 fracture with up to 4 mm odontoid destraction and 2 mm posterior displacement • Diagnosis of quadriplegia • Full supportive measures instituted at family request

  10. Mechanical Chest Compression Indications • Adult patients with medical cardiac arrest • Cases where manual chest compression would be used Consider Spinal Precautions !

  11. Thank you Joseph Barger, MD Contra Costa County EMS joe.barger@hsd.cccounty.us Pam Dodson Contra Costa County pam.dodson@hsd.cccounty.us

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