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technique of emergency pericardiocentesis

  • aseptic technique if possible
  • identify landmarks:
    • left paraxiphoid (traditional)
    • left parasternal (4th intercostal space left parasternal)
  • for a left paraxiphoid approach:
    • 45 deg to the abdominal wall, head for the left shoulder, aspirate as you go
    • optionally attach a V lead to the base of the needle and watch ECG to look for a change in the QRS morphology, or ST elevation which indicates the needle has contacted the myocardium
    • aspirate fluid/blood
    • consider placing a catheter/pigtail
  • NB. blood stained pericardial fluid will not clot whereas intraventricular blood will
pericardiocentesis.txt · Last modified: 2013/07/19 15:48 (external edit)