Question: What is the purpose of CPR?

But it's not going to drive the xiphoid into the heart like you suggested. There's a big difference between a sternal fracture which happens in even properly performed CPR and what you were suggesting. Even "improperly" it's not going to work and your knowledge of injury mechanisms and biomechanics, not to mention general anatomy, seems to be quite lacking. If you want to dance with me further on this one, feel free but remember why my non-clinical job is and the resultant knowledge that goes along with it.
 
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The NIH article cites one fluke occurrance in Australia.

It was sternal and included osteomyelitis. A little sidebar article cited by the website mentions sternal fracture due to electroverversion (say what?). I appreciate seeing a reference though versus reading as we so often do "My EMT instructor told me...".
 
Also, I would like to point out that there's a difference between "improperly done" and "experienced a complication". There's nothing to indicate that it was not done correctly so honestly the article (which I pulled and read in full) is not even germane to this discussion. After reading it, my guess is that the person who posted it did a quick Pubmed search, found something that sounded like it might be applicable (despite it NOT being the same scenario he originally mentioned nor the same injuries) and posted it thinking it would suffice.
 
Check search for another thread about xyphoids.

Just saying (cause we aren't supposed to do that...);)
 
Maybe off centered CPR fracturing a rib right near the sternum? Still no evidence though. I don't see how the xiphoid would make it all the way up to your heart.
 
You'd have to be pretty far off the mark to fracture a rib as you have a couple of inches of costal cartilage in most people and you're not going to get that large of a displacement (sufficient to penetrate the anterior wall of one of the ventricles) without direct and extreme force both in terms of strength and the shape of the impulse.
 
Did you mean Liver? Because that was what I was always taught the Xiphoid would lacerate
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It can, but it's not as common as a lot of people believe because of the anatomy involved and the ability of the liver to be pushed out of the way somewhat.
 
usafmedic45 said:
After reading it, my guess is that the person who posted it did a quick Pubmed search, found something that sounded like it might be applicable (despite it NOT being the same scenario he originally mentioned nor the same injuries) and posted it thinking it would suffice.
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This I will admit to as I did on my phone and only quickly skimmed the article. Now that I am on my computer, I am able to do more research and, I have found numerous "sources" that claim damage to the xyphoid process can cause heart damage though piercing is never a word used, however these sources are not published articles hence the quotes.

As far as the anatomy lesson goes and please correct me if I am wrong but my understanding is that the xyphoid is located just below the intersection of the 6th coastal cartilage. If we take a look at a chest x-ray and ( I am keeping in mind that things are not anatomically perfect) count down to the sixth rib and follow it to the sternum there would be some heart below that. I am not implying that this would for sure happen just that there is a very slim chance that the xyphoid could break off and cause damage to the heart. In the future Instead of insulting my intelligence and and basically calling me an idiot why don't you use your knowledge and explain to me why you think I am wrong so I can understand you reasoning and learn something I didn't know before. Everyone on this site is at a different level in their education and life and some come here to learn from others, not to be insulted and put down. If you thought or still think I am wrong then explain to me what you thing the right answer is and don't be a jerk about it.

What about a person with a congenitally enlarged heart?
I definitely agree that it is MORE likely to cause damage to the liver or even the diaphragm if broken off.
What do you think about damage to the pericardium?

On an interesting side note in my quest for a peer reviewed article, I came across this http://www.ncbi.nlm.nih.gov/pmc/articles/PMC472083/pdf/thorax00108-0112.pdf An article that describes a complication of pectus excavatum where a cartilagenous horn on the xyphoid actually rubs on the heart. In this case I would think it would definitely be possible to impale the xyphoid into the heart. :ph34r:

As I said before please feel free to correct me as I am here to learn.
 
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