Is It Harmful to Perform CPR on Someone with a Fractured Skull and Brain Damage?

Undetected Injuries and Their Implications

To be honest, one could argue that unless you notice blood or clear fluid coming out of a person's ears, you might not suspect any severe brain injury. This was the case a few days ago when I assisted a man involved in a rather traumatic crash.

The man, who had faced a dramatic fall over the handlebars of his bike and landed face-first on the ground, was initially unresponsive when I arrived on the scene. However, upon regaining consciousness and with the helmet removed, his behavior became increasingly erratic and concerning.

Despite these unusual reactions, his neurological observations were within expected limits, indicative of a loss of consciousness due to a brief period of trauma, and his pupils were equal and reactive. It was only later that I was informed that he had suffered a fractured skull and a subdural hematoma, or brain bleed.

Performing CPR: Harmful or Not?

Typically, if a patient is unresponsive and not breathing, even without noticeable outward injuries, performing CPR is indicated. In the case of cardiac arrest, the answer is unequivocally no; the scenario of a person being 'dead' being the worst possible condition for a human implies that any intervention to restore circulation and oxygenation is beneficial.

The Importance of Observations and Professional Judgment

Observations played a crucial role in assessing the man's condition, but the absence of specific signs such as cerebrospinal fluid (CSF) leaks or other clear indicators might lead one to overlook underlying injuries. It is essential to proceed with caution and rely on professional judgment, especially in emergency situations where immediate action can be life-saving.

Conclusion

When faced with a patient who is unresponsive and not breathing, performing CPR is absolutely essential and not harmful, especially in cases of cardiac arrest. The key is to act quickly based on the signs of cardiac arrest and avoid any unnecessary hesitation that might delay life-saving measures.