User:Mr. Ibrahem/Pericardiocentesis
| Mr. Ibrahem/Pericardiocentesis | |
|---|---|
 Drawing of a pericardial effusion, needle pictured is not generally long enough. | |
| Specialty | Emergency medicine, cardiology |
| Complications | Injury to the heart, arrhythmia, pneumothorax, injury to the liver[1] |
Pericardiocentesis (PCC), also called pericardial tap, is a procedure where fluid is removed from the envelope around the heart (pericardial sac).[1] Emergently it is most commonly carried out for pericardial tamponade resulting in low blood pressure.[1] Tamponade typically results from a stab wound to the chest rather than blunt trauma.[4] The procedure may also be done less urgently when a moderate effusion results in symptoms.[3]
To preform the procedure sterilize and freeze the area.[1][5] The needle is often inserted below the lower part of the sternum, through may be inserted through the front of the chest.[1] A 20g spinal needle with a 10 ml syringe or the needle from a central line kit may be used.[5] The path can be guided with an ultrasound.[1] The Seldinger technique can be used to leave a pigtail drain in place.[1][5]
Complications can include injury to the heart, arrhythmia, pneumothorax, and injury to the liver.[1] Placing a nasogastric tube to decompress the stomach before the procedure may lower the risk of stomach injury.[1] Signs of success include improved blood pressure and this generally occurs rapidly.[1][3] After the procedure the person may be brought to the operating room for further procedures such as a pericardial window or thoracotomy.[1] The procedure was first described in 1911 by Marfan.[3]
References[edit]
- ^ a b c d e f g h i j k l m n Willner, DA; Grossman, SA (January 2021). "Pericardiocentesis". PMID 29261871.
{{cite journal}}: Cite journal requires|journal=(help) - ^ Roberts and Hedges' clinical procedures in emergency medicine and acute care (Seventh ed.). Philadelphia, PA: Elsevier Health Sciences. 2019. pp. 309–331. ISBN 9780323547949.
- ^ a b c d Carlini, Caterina Chiara De; Maggiolini, Stefano (11 October 2017). "Pericardiocentesis in cardiac tamponade: indications and practical aspects". www.escardio.org. 15 (19). Retrieved 17 March 2021.
- ^ Surgical care at the district hospital (PDF). Geneva: World Health Organization. 2003. p. PTCM-18. ISBN 9241545755. Retrieved 16 March 2021.
- ^ a b c Nagdev, Arun (22 August 2013). "Ultrasound-Guided Pericardiocentesis". ALiEM. Retrieved 16 March 2021.