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close this bookMinor Surgical Procedures in Remote Areas (MSF, 1989, 172 p.)
close this folderChapter 3: Catheterisation and drainage
View the documentCatheterisation of large veins
View the documentLumbar puncture
View the documentPleural puncture
View the documentThoracic drainage
View the documentPericardial puncture
View the documentDrainage of ascites and intra-peritoneal perfusion
View the documentPuncture and drainage of the knee

Pericardial puncture

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


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.


· 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.