CPR and Cracked Sternums

Nurses General Nursing

Published

Hi All,

This is my first post other than saying hello! Thanks to all for being here and posting!

I did have a question though, while looking into taking a CPR class today, someone mentioned that actual CPR, done correctly, will almost ALWAYS end up cracking the injured's sternum, and that "frankly," (that was the term she used) until it cracks, you won't get the best compression.

I was just really curious about this, as it seemed odd to me. If you are performing CPR, and crack the sternum, then wouldn't you crack ribs as well? :imbar

Any thoughts, ideas, or places on the web for further research?

I can understand that a cracked sternum that ends up saving one's life is better than letting them die, I guess I didn't realize the CPR could be so invasive, or injurious, for lack of a better term.

Thanks all! :)

Specializes in MICU, SICU, CICU.

The last time I did CPR I broke multiple ribs with the first compression. By the end of the code I had broken almost her entire rib cage.

CPR is very invasive

Specializes in Med-surg > LTC > HH >.

I just wonder if I would be able to do cpr correctly. I don't know if I'm strong enough to break someones ribs or sternum. :coollook:

CPR is very invasive

Thanks folks, I didn't realize this. I have tried searching on the web for CPR and "cracked sternum," but it hasn't been very successful.

Does one feel this instantly? I would think that would scare or deter lay people from even attempting it. I mean, who wants to get sued for injuring someone else?

Specializes in MICU, SICU, CICU.
Thanks folks, I didn't realize this. I have tried searching on the web for CPR and "cracked sternum," but it hasn't been very successful.

Does one feel this instantly? I would think that would scare or deter lay people from even attempting it. I mean, who wants to get sued for injuring someone else?

Yes you can feel when you break bones. I felt distinct pops under my hands with compressions. I'm not too sure about cracking the sternum, but you will definitely break ribs.

CPR is brutal, for both the patient and the caregiver. The first few times I did chest compressions my arms were very sore the next day! Frankly, if you aren't breaking a few ribs (on the patient!) you probably aren't doing it right. It's very tough to get good, effective compressions on most people, especially those who have extra tissue (either muscle or fat) around the chest and abdomen.

And for what it's worth, I've more commonly seen/felt ribs breaking loose from the sternum, rather than breaking the sternum itself. Just remember, broken ribs will heal. Dead won't.

If you are doing it right, they are dead when you start compressions, since their heart is not pumping. If they think about it, cracked or broken ribs are preferable to the alternative. If you break something, (It's not compulsory!) you kind of hear it more than feel it.

And for what it's worth, I've more commonly seen/felt ribs breaking loose from the sternum, rather than breaking the sternum itself. Just remember, broken ribs will heal. Dead won't.

Ah, that seems to make sense. Does anyone worry about being sued for this? I mean, certainly nurses / doctors always have that hanging over their heads, but lay people may be very hesitant to commit to such things.

Yes dead won't heal, but neither will a suit, unfortunately.

Rush

People can sue for anything, but suing someone for saving your life (in the absence of a DNR, of course) is likely to get you laughed out of court - not to mention, people might be less likely to strain themselves to save it again. Realistically, however, patients who require CPR rarely have long enough post-resuscitation survival rates to worry about suing the people that broke their ribs.

Specializes in Neuro/Med-Surg/Oncology.

Don't forget about the Good Samaritan Act too. You're covered.

I used to work with an RN who gave people a really good speech about CPR and the possibility of cracked ribs, punctured lungs, possiblity of xyphoid process snapping, etc. and the possible damage to the body if survival occurs. She dealt mainly with very frail, medically complex elderly patients who wanted all the bells and whistles.

It was surprising how many changed their minds or family members who now didn't want their parents to be full codes. To be blunt, 98 yrs, blind, diabetic amputee with two cancers wanting a full code at the families insistance? There is a time and place for CPR but sometimes we should be realistic.

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