Emergency care in patients wearing body casts

Area of Science:

• Orthopedic surgery
• Emergency medicine
• Biomedical engineering

Background:

• Body casts are essential for immobilizing patients but can impede rapid access for cardiopulmonary resuscitation (CPR).
• Cardiopulmonary arrest occurs in 3% to 5% of hospitalized patients, necessitating quick emergency interventions.
• Existing cast removal methods are time-consuming, delaying critical resuscitation efforts.

Purpose of the Study:

• To describe a modified body cast design enabling rapid chest access for CPR.
• To evaluate the incidence of cardiopulmonary arrest in patients wearing body casts.
• To assess the safety and efficacy of perforated body casts in emergency situations.

Main Methods:

• Body casts were perforated at various intervals (1/2", 1", 2") using a vibrating drill.
• Chest piece removal times were measured using a cast saw.
• Engineering studies evaluated cast shell strength with and without perforations under load.
• Clinical observation of 40 perforated casts worn for 12 weeks assessed for failure.

Main Results:

• Chest exposure time was reduced from 1-3 minutes to 15 seconds for fiberglass and plaster casts, respectively.
• Perforated casts maintained structural integrity, supporting up to 330 pounds of force.
• No cast failures were observed in 40 patients wearing casts with 1-inch interval perforations for 12 weeks.

Conclusions:

• Perforated body casts provide a significant time advantage for initiating CPR.
• The modification does not compromise cast strength or patient safety.
• This innovation can improve outcomes for hospitalized patients experiencing cardiopulmonary arrest while immobilized.