Traumatic pneumocephalus: a hazard of resuscitators

A patient with traumatic pneumocephalus following use of an oxygen-powered resuscitator with a face mask is presented. Pressures of 50 cm H2O delivered by the device apparently were sufficient to force air into the cranium through a fracture communicating with the nasal cavity. The authors feel that manual-powered resuscitators should be used on patients suspected of skull fracture.