Cardiopulmonary Resuscitation (CPR) is a life-saving procedure performed when someone’s breathing or heart stops, such as during cardiac arrest. This emergency technique maintains blood flow to the brain and other vital organs, offering a chance of survival until medical help arrives. While CPR is powerful, questions often arise about potential injuries, particularly to the sternum. Understanding these aspects clarifies the procedure’s mechanics and outcomes.
Anatomy of the Sternum
The sternum, commonly known as the breastbone, is a flat bone located in the central front part of the chest. It serves as a protective shield for the heart, lungs, and major blood vessels within the chest cavity. The sternum is divided into three distinct parts.
The uppermost section is the manubrium, a broad, handle-like portion where the collarbones and the first two pairs of ribs attach. Below the manubrium lies the body of the sternum, the longest and widest part. The third through seventh pairs of ribs connect directly to the body of the sternum via cartilage. The lowest and smallest part is the xiphoid process, a cartilaginous tip.
Common Injuries During CPR
Performing CPR requires significant force for effective chest compressions, leading to injuries to the sternum and surrounding structures. The American Heart Association recommends compressions be at least 2 inches deep but no more than 2.4 inches for adults, delivered at a rate of 100 to 120 compressions per minute. Approximately 30-60% of adult CPR cases involve at least one broken rib or sternum fracture.
Fractures of the xiphoid process are common. Rib fractures are also frequently observed, particularly in the third through sixth ribs, which lie directly under the compression point. While less frequent than rib fractures, the sternal body itself can also fracture. Such injuries, while concerning, often indicate that compressions were performed with adequate depth and force to circulate blood.
The Unwavering Priority of Life
Despite the potential for sternum or rib fractures, the objective of CPR is to save a life by maintaining blood flow to the brain and other organs. Without CPR, brain damage can occur in as few as three minutes, leading to irreversible injury after about seven minutes. The risk of these injuries is significantly outweighed by the immediate threat of death if CPR is not performed.
Immediate CPR can double or even triple the chance of survival from cardiac arrest. While proper training helps minimize risks, injuries can still occur and are an acceptable consequence compared to cardiac arrest without intervention. The focus remains on delivering high-quality compressions to ensure the best possible outcome for the individual in need.