Cardiac tamponade treatment
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S.
Overview
Initial treatment given will usually be supportive in nature, for example administration of oxygen, fluid repletion and monitoring.
Pre-hospital care
- There is little care that can be provided pre-hospital other than general treatment for shock.
- Some pre-hospital providers will have facilities to provide pericardiocentesis, but this is generally futile if the patient has already suffered a cardiac arrest before arrival of the healthcare professional to undertake the procedure [1], and so rapid evacuation to a hospital is usually the more appropriate course of action.
Hospital management
Initial management in hospital is by pericardiocentesis [2]. This involves the insertion of a needle through the skin and into the pericardium, and aspirating fluid. Often, a cannula is left in place during resuscitation following initial drainage so that the procedure can be performed again if the need arises. If facilities are available, an emergency pericardial window may be performed instead [3], during which the pericardium is cut open to allow fluid to drain. Following stabilization of the patient, surgery is provided to seal the source of the bleed and mend the pericardium.
References
- ↑ Greaves, I., Porter, K. (2007). Oxford handbook of pre-hospital care. Oxford: Oxford University Press ISBN 9780198515845
- ↑ Gwinnutt, C., Driscoll, P. (Eds) (2003) (2nd Ed.) Trauma Resuscitation: The Team Approach. Oxford: BIOS Scientific Publishers Ltd. ISBN 978-1859960097
- ↑ Gwinnutt, C., Driscoll, P. (Eds) (2003) (2nd Ed.) Trauma Resuscitation: The Team Approach. Oxford: BIOS Scientific Publishers Ltd. ISBN 978-1859960097