10th May 2025

Cardiac Tamponade

The patient will most likely be shocked, and so in the first instance should be provided with oxygen,  volume expansion with crystalloid fluid, lower limb elevation. Vasopressor support may be needed. The  definitive treatment will involve removing the fluid in the pericardial space that is causing haemodynamic compromise by bedside pericardiocentesis. This is performed either using traditional landmark technique  in a sub-xiphoid window or using a point-of-care echo to guide needle placement in real-time. Patients  may also undergo a thoracotomy using the ‘clam shell’ approach, but this is reserved for traumatic arrests  with suspected tamponade.