Accuracy of intracardiac injections determined by a post-mortem study

Abstract

Intracardiac injection sites were traced at necropsy on 18 patients who died after unsuccessful cardiopulmonary resuscitation. In only 13 patients (72%) was the heart punctured. Of the 46 injections carried out, 5 (11%) pierced the left ventricle and 13 (28%) the right ventricle. Other structures punctured included the pulmonary trunk, the aorta, and the lung. The fourth intercostal space just lateral to the sternal edge was the commonest injection site, and only 5 injections were subxiphoid. Post-mortem injections on a further 20 cadavers confirmed that the right ventricle is the most frequent puncture site whichever approach is used.