Injury to a cardiopulmonary resuscitation provider by sternal wire

Background

Median sternotomy is a common surgical procedure during cardiac and pulmonary surgeries. There are many reports of patient injury associated with wire breakage. However, there are only a few reports of healthcare worker injuries by sternal wire.

Case Presentation

A patient in his 70s, having a history of thoracic aorta replacement, collapsed suddenly and paramedics started mechanical chest compression. On hospital arrival, the emergency department nurse attempted to initiate manual chest compression but was injured by a sternal wire protrusion on the patient's chest. The emergency physician placed gauze on the sternal wire and continued manual chest compression, but the patient died.

Conclusion

To prevent this injury, cardiopulmonary resuscitation (CPR) providers should consciously check the patient's chest. If they observe wire exposure, they should immediately place a gauze, pad or consider performing mechanical chest compression. Safety measures such as the installing rubber pads in the AED should be considered.