Life saved after alert necklace leads to stronger CPR compressions in 17-year old with Pectus bars

Updated: Jun 21

A published case report in medical journal International Journal of Surgery Case Reports strongly recommends that Pectus patients with Nuss bar implants wear a medical alert bracelet or necklace.

Prior work has suggested that more force during cardiopulmonary resuscitation (CPR) might be necessary for individuals with Nuss bar implants compared to typical CPR situations. The Nuss bars are rigid steel bars that might reduce the effectiveness of regular chest compressions during CPR.

In the first case reported of its kind, a 17-year-old male with pectus excavatum underwent the Nuss procedure with two 13-inch bars implanted. Approximately two years after the surgery, the patient collapsed while at the beach likely due to a seizure. He became unresponsive.

Lifeguards were on the scene ready to begin life supportive care. Another adult that knew the patient called the patient's mother, who directed attention to a medical alert necklace which indicated substernal steel bars were present and more force for CPR would be necessary.

The lifeguards followed this recommendation. An automatic external defibrillator was used and compressions were continued until the fire rescue team arrived. The patient's vital signs returned to normal and the patient was transported to a local hospital.

This is the first case of CPR with implanted Nuss bars. It is unknown whether the life saving measures would have been effective if the patient was not wearing an alert necklace and the compressions were of regular strength. The authors recommend that CPR providers should learn about special precautions needed for individuals with Nuss bar implants.

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