Pericardial puncture

Puncture between the two layers of the pericardium to evacuate fluid (blood or serous).

Indication

Tamponade, massive cardiac collapse.

Diagnostic signs

· 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.

Material

· Short bevel catheter of 16 G

· 50 ml syringe

· Sterile drapes with a hole

· Sterile gloves

· Polyvidone iodine (see table page 7)

Technique

· 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.

Incident

Perforation of the inferior wall of the heart: withdraw the needle a little.

FIGURE

FIGURE