We discuss a patient with a penetrating knife wound to the chest who lost pulses from cardiac tamponade. Prehospital ultrasound was able to quickly identify the tamponade and a pericardiocentesis was performed using a Simplified Pneumothorax Emergency Air Release (SPEARTM) Needle (North American Rescue, LLC, USA) with subsequent return of spontaneous circulation. Penetrating chest trauma carries significant morbidity and mortality. In traumatic cardiac arrest due to a penetrating mechanism, it is paramount that the patient be transported to a trauma center as quickly as possible. Prehospital pericardiocentesis is a potential life-saving intervention.
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http://dx.doi.org/10.1080/10903127.2021.1977441 | DOI Listing |
Air Med J
June 2024
BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI; Med Flight, University of Wisconsin-Madison Hospitals and Clinics, Madison, WI. Electronic address:
Point-of-care ultrasound (POCUS) has been shown to be a valuable tool in the management of acutely ill patients in the prehospital setting. POCUS not only has utility from a diagnostic perspective but also has been shown to reduce the rate of complications from otherwise traditionally "blind" procedures, such as pericardiocentesis. This case report highlights the utility of POCUS in the prehospital setting to guide emergent pericardiocentesis to treat cardiac tamponade.
View Article and Find Full Text PDFDiagnostics (Basel)
February 2024
Geriatric Medicine Residency Program, University of Rome "Tor Vergata", 00133 Rome, Italy.
Point-of-Care Ultrasound (POCUS) is a rapid and valuable diagnostic tool available in emergency and intensive care units. In the context of cardiac arrest, POCUS application can help assess cardiac activity, identify causes of arrest that could be reversible (such as pericardial effusion or pneumothorax), guide interventions like central line placement or pericardiocentesis, and provide real-time feedback on the effectiveness of resuscitation efforts, among other critical applications. Its use, in addition to cardiovascular life support maneuvers, is advocated by all resuscitation guidelines.
View Article and Find Full Text PDFAir Med J
January 2024
Royal Flying Doctors Service South Eastern Section, Surry Hills, New South Wales, Australia.
Pericardiocentesis is a high-acuity, low-occurrence procedure rarely performed by emergency and retrieval clinicians. We present a case of cardiac tamponade secondary to coronavirus disease 2019 managed with prehospital pericardiocentesis in remote Australia, 800 km from the nearest hospital. This was performed using a quadruple-lumen central venous catheter.
View Article and Find Full Text PDFAm J Emerg Med
December 2021
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan.
Background: The outcomes of patients with cardiac arrest induced by non-traumatic hemorrhagic cardiac tamponade are poor.
Purpose: We retrospectively investigated the significance of medical intervention with pericardiocentesis and/or pericardiotomy for non-traumatic hemorrhagic cardiac tamponade.
Methods: From January 2013 to April 2021, we retrospectively reviewed the medical charts of all patients with cardiac arrest in a prehospital setting or emergency room due to cardiac tamponade confirmed by an ultrasound examination with or without an invasive procedure (pericardiocentesis and/or pericardiotomy) and computed tomography findings, including those obtained at autopsy imaging.
Shock
February 2022
Department of Cardiothoracic and Vascular Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Background: The pre-hospital use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is increasing, although it remains controversial, in part because of suggested contraindications such as acute cardiac tamponade (ACT). As both the pre-hospital and in-hospital use of REBOA might potentially occur with concurrent ACT, knowledge of the hemodynamic effect of REBOA in this setting is crucial. This study, therefore, aimed at investigating the physiological effects of REBOA in hemodynamic instability secondary to ACT in a porcine model.
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