You arrive on the scene where a person without a pulse was found. Someone on the scene performed CPR, but the individual unfortunately could not be revived. On postmortem examination, it is discovered that several ribs and the xiphoid process were fractured. What likely caused these fractures?

Verified step by step guidance

1. Step 1: Understand the context of the situation. The individual was found without a pulse, and CPR was performed.
2. Step 2: Recognize that CPR involves chest compressions, which are performed to manually pump blood through the heart when it is not beating.
3. Step 3: Note that during CPR, compressions are applied to the sternum, which can exert pressure on the ribs and the xiphoid process.
4. Step 4: Consider that the force applied during chest compressions can sometimes lead to fractures, especially in the ribs and the xiphoid process, due to the pressure exerted on the chest.
5. Step 5: Conclude that the fractures of the ribs and xiphoid process were likely caused by the forceful chest compressions performed during CPR.

Key Concepts

Cardiopulmonary Resuscitation (CPR)

CPR is an emergency procedure performed to manually preserve brain function and restore blood circulation in a person who has stopped breathing or whose heart has stopped beating. It involves chest compressions and rescue breaths, which can exert significant force on the chest, potentially leading to injuries such as rib fractures, especially in older adults or those with fragile bones.

Rib Fractures

Rib fractures occur when excessive force is applied to the rib cage, often resulting from trauma or medical procedures like CPR. These fractures can be classified as simple or complicated, with the latter potentially leading to punctured lungs or other internal injuries. The likelihood of rib fractures increases with age and pre-existing conditions that weaken bone density.

Xiphoid Process

The xiphoid process is the small, cartilaginous extension at the lower end of the sternum. It is a critical landmark in CPR, as proper hand placement during chest compressions is essential to avoid injury. Fractures of the xiphoid process can occur during aggressive CPR, particularly if compressions are performed too low on the sternum or with excessive force.