Emergency treatment of cardiac tamponade is:
|B||Immediate needle aspiration of pericardial sac|
|C||Rapid blood transfusion|
|D||Positive pressure transfusion|
a. Once the diagnosis of cardiac tamponade is established, pericardiocentesis should be performed .
b. Evacuation of as little as 15 to 25 mL of blood may dramatically improve the patient's hemodynamic profile.
c. Pericardiocentesis should be done even if the patient appears to stabilize with volume loading since subclinical myocardial ischemia can lead to sudden lethal arrhythmias, and patients with tamponade may decompensate unpredictably.
d. While pericardiocentesis is being performed, preparation should be made for emergent transport to the OT.
e. Emergent pericardiocentesis is successful in decompressing the tamponade in approximately 80% of cases; most failures are due to clotted blood within the pericardium.
f. If pericardiocentesis is unsuccessful and the patient remains severely hypotensive (SBP <70 mm Hg) or shows other signs of hemodynamic instability, ED thoracotomy should be performed.