Case No. 163

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Case No. 163

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Chief Complaint:

Stabbed in the chest

Published: Dec. 2, 2017
Case No. 163
Author: jason.lopez
CASE SCENARIO

A 25-year-old male is involved in a physical altercation and presents to the Emergency Department with a puncture wound to his mid-chest. The patient is agitated, diaphoretic, dyspneic, and complaining of crushing chest pain. On examination his vital signs are: HR 155, BP 74/40, RR 32, O2sat 98% on NRB. An emergent bedside echocardiogram is performed which shows a pericardial effusion with collapse of the right ventricle during diastole. You correctly diagnose the patient as having cardiac tamponade and want to perform a bedside pericardiocentesis.

QUESTION

Which statement is correct regarding pericardiocentesis?

An emergent pericardiocentesis should not be performed in someone with a severe bleeding disorder.
Traumatic effusion is an absolute contraindication to pericardiocentesis as patients can re-accumulate blood in the pericardial space.
There are no absolute contraindications to an emergent pericardiocentesis
An emergent pericardiocentesis should not be performed in someone with normal vital signs
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