Quote:
Originally posted by greg c
bdonham has it nailed, I would guess pericardiocentesis is the word you are going for. I have done it ten times or so, usually at code arrest settings in the hospital. Not technically difficult, but anytime you blindly are sticking sharp pointy things into people, you'd better hope your anatomic landmarks are reliable. I would imagine that this could be a problem in a trauma setting.
-G
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what were your indications for doing a pericardiocentesis since I am assuming they were medical codes? Any survivors?
I have taken residents through pericardiocentesis on a few occasions.... no survivors. The patient is usually s/p a motor vehicle condition in full arrest and on arrival we do bilateral chest tubes and pericardiocentesis to basically treat reversible causes of the arrest if they are present (tamponade or tension pneumothoraces...this may partially answer one of NDD's other questions...)
The other grop that may benefit are those with penetrating injuries in whom you suspect tamponade and in my hands they would undergo a thoracotomy instead either emergently or urgently depending on the scenerio and hemodynamic status of the patient.
I have, in my experience, two neurologically intact survivors of ER thoracotomy from pericardial tamponade from stab wounds.....both could have had a pericardiocentesis initially to try and revive them if the capabilities for an ER thoracotomy weren't available.
Contrary to popular belief however, pericardial blood does clot and this cannot be evacuated through a catheter.
doc t.