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J Forensic Sci. 2013 Jul;58(4):904-9. doi: 10.1111/1556-4029.12146. Epub 2013 May 21.

Manual and automated cardiopulmonary resuscitation (CPR): a comparison of associated injury patterns.

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Harris County Institute of Forensic Sciences, 1885 Old Spanish Trail, Houston, TX 77054, USA.


The purpose of this study was to identify and compare patterns of trauma associated with AutoPulse(®) CPR and manual CPR. Finalized autopsy records from 175 decedents brought to the Harris County Institute of Forensic Sciences were reviewed, 87 received manual-only CPR, and 88 received AutoPulse(®) CPR (in combination with manual CPR as per standard protocol). The characteristic pattern observed in manual-only CPR use included a high frequency of anterior rib fractures, sternal fractures, and midline chest abrasions along the sternum. The characteristic pattern observed in AutoPulse(®) CPR use included a high frequency of posterior rib fractures, skin abrasions located along the anterolateral chest and shoulder, vertebral fractures, and a few cases of visceral injuries including liver lacerations, splenic lacerations, and hemoperitoneum. Knowledge of the AutoPulse(®) CPR injury pattern can help forensic pathologists differentiate therapeutic from inflicted injuries and therefore avoid an erroneous assessment of cause and manner of death.


AutoPulse®; cardiopulmonary resuscitation; device-assisted cardiopulmonary resuscitation; forensic pathology; forensic science; trauma

[Indexed for MEDLINE]

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