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    Cardiac Tamponade Guideline

    Uploaded by

    Prasant Ganesen
    GUIDELINE FOR PBSM MEMBERS...ADDTIONAL NOTES ABOUT CARDIAC TAMPONADE..VERY USEFUL THE PEOPLE WHO TAKING PFA EXAM AND WILL HELP ALL THE PBSM MEMBERS IN THEIR CAREER.CARDIAC TAMPONADE IS ABOUT HUMAN HEART AND THEIR FUNCTION...

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    Cardiac Tamponade Guideline

    Uploaded by

    Prasant Ganesen
    161 views11 pages
    GUIDELINE FOR PBSM MEMBERS...ADDTIONAL NOTES ABOUT CARDIAC TAMPONADE..VERY USEFUL THE PEOPLE WHO TAKING PFA EXAM AND WILL HELP ALL THE PBSM MEMBERS IN THEIR CAREER.CARDIAC TAMPONADE IS ABOUT HUMAN HEART AND THEIR FUNCTION...

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    GUIDELINE FOR PBSM MEMBERS...ADDTIONAL NOTES ABOUT CARDIAC TAMPONADE..VERY USEFUL THE PEOPLE WHO TAKING PFA EXAM AND WILL HELP ALL THE PBSM MEMBERS IN THEIR CAREER.CARDIAC TAMPONADE IS ABOUT HUMAN HEART AND THEIR FUNCTION...

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    161 views11 pages

    Cardiac Tamponade Guideline

    Uploaded by

    Prasant Ganesen
    GUIDELINE FOR PBSM MEMBERS...ADDTIONAL NOTES ABOUT CARDIAC TAMPONADE..VERY USEFUL THE PEOPLE WHO TAKING PFA EXAM AND WILL HELP ALL THE PBSM MEMBERS IN THEIR CAREER.CARDIAC TAMPONADE IS ABOUT HUMAN HEART AND THEIR FUNCTION...

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 11

    Cardiac Tamponade

    Cardiac Tamponade

    Clinical signs
    Pulsus paradoxus
    It is an exaggerated drop (> 10mm Hg) in the systolic
    arterial blood pressure upon inspiration.

    ** palpate the brachial or radial pulse maximally, slowly


    decreasing your pressure on the pulse while watching the
    patient breathe. If pulsus paradoxus is present, you will
    get to a point where the pulse during inspiration decreases
    or disappears, while it remains palpable during expiration.

    Cardiac Tamponade

    Clinical signs..
    Pericardial friction rub may be present
    Heart size on x-ray may be normal
    or enlarged
    Echocardiogram

    Pericardial Tamponade

    Note rounded bottle shape to left


    side of heart
    Compare with next 2 slides

    Chest x-ray
    Widened mediastinum
    Pneumo- or hemothorax
    Electrical alternans

    Cardiac Tamponade

    Pathophysiology
    Impairment of ventricular diastolic filling caused by
    pressure of pericardial sac
    And by bulging of ventricular septum
    into LV
    Stroke volume and cardiac output fall
    5

    Pericardiocentesis

    Indications
    Immediate threat to life
    Severe hemodynamic impairment
    Fall in systolic blood pressure >30 mm Hg

    Pericardiocentesis

    General principles
    As of 2000 = echocardiography used to
    guide pericardiocentesis
    Direct subxyphoid techniques only used in
    dire medical emergency
    ECG and hemodynamic monitoring
    Full resuscitation equipment available
    7

    Pericardiocentesis

    Equipment
    16-gauge short-bevel large-bore needle
    30- or 50-mL syringe
    Echo- or ECG-guided (V lead)
    Local anesthetic
    Sterile supplies and povidone-iodine
    solution
    8

    Pericardiocentesis

    Technique
    Patient in supine position, upper
    torso elevated
    ECG limb leads attached to patient
    Use echocardiography guided procedure
    (rarely: ECG-guided, V lead)
    Subxiphoid approach
    Continuous aspiration
    9

    Pericardiocentesis

    For historical interest: ECG-guided


    needle advancement

    10

    Pericardiocentesis

    Hazards
    Cardiac arrhythmias
    Laceration of myocardium or
    coronary arteries
    Injection of air into cardiac chambers
    Hydrothorax or pneumothorax
    Hemorrhage from laceration may
    produce tamponade
    11

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