CS14-080 Second Degree Arm Burn: An Unexpected Sequelae of a Routine CPR

Takkin Lo, MD, MPH, CWSP, ABPM-UHM, Loma Linda Univeristy Medical Center, MD, MPH, Loma Linda, CA, Ashish Sharma, DDS, Dentistry, Loma Linda University School of Dentistry, Loma Linda, CA, Cassaundra A. Song, MHID, Loma Linda University Medical Center, Research Assistant, Loma Linda, CA, Abdullah Alismail, MS, RRT-NPS, Cardiopulmonary Sciences, Loma Linda University School of Allied Health, Loma Linda, CA and Evelyn Massey, MD, Life Support Education, Loma Linda, CA
Background

There have not been any published studies discussing serious wounds to a victim’s body surface as a result of Cardiopulmonary Resuscitation (CPR). Out-of-hospital cardiac arrest (OHCA) is experienced by millions of people worldwide [1]. CPR is an important component to victim survival of OHCA [2]. We report a case where an OHCA victim received deep 2nd degree arm burns as a result of CPR.

Case

A 33-year-old female had an OHCA in an outdoor university parking lot. The victim was wearing a short sleeve blouse, which resulted in direct contact of her skin to the hot asphalt of the parking lot. The recorded temperature of the day was 105° F with CPR lasting 15-20 minutes.  No attempt was made to minimize the exposure of her bare skin against the hot asphalt. The victim was surprised to discover she sustained deep 2nd degree burns to the dorsal surface of her right arm (9x4 cm2) and fore arm (8x3 cm2).  The patient was referred to an outpatient wound clinic where her wounds were found to be erythematous, uneven in consistency,with signs of slight drainage and with minimal epithelial bridging. There was also significant tenderness of the wounds. She was prescribed silver sulfadiazine cream and was recommended to cover the wound sites with a foam dressing and stretch gauze bandages. Noncontact, low frequency ultrasonic saline therapy was done on the wound site three times a week for four weeks.  After 10 months of definitive wound care the patient continues to have scarring from both of the wounds.

Conclusions

This case report highlights the importance of assessing the surfaces onto which CPR is performed.  A lack of attention to surface evaluation may result in a lengthy recovery from deep second-degree burns and eventual permanent scarring.