|Minor Surgical Procedures in Remote Areas (MSF, 1989, 172 p.)|
|Chapter 3: Catheterisation and drainage|
Puncture between the two layers of the pericardium to evacuate fluid (blood or serous).
Tamponade, massive cardiac collapse.
· Dyspnea, anxiety, syncope.
· Distended juguler veins.
· Tachycardia and disappearing heart sounds.
· Falling blood pressure, reduce difference between systolic and diastolic blood pressure, systolic pressure falling with deep inspiration.
· Short bevel catheter of 16 G
· 50 ml syringe
· Sterile drapes with a hole
· Sterile gloves
· Polyvidone iodine (see table page 7)
· Rigorous asepsis.
· Fix the needle to the syringe.
· Introduce the needle to the left of the xyphoid process at an angle of 45° to the skin.
· Point the needle towards the right shoulder advancing and aspirating until blood appears.
Perforation of the inferior wall of the heart: withdraw the needle a little.