EMRA Simulation Guide

CARDIOVASCULAR - Pericardial Tamponade

CASE: 24-year-old male presents with a stab wound to the left 3rd intercostal space at the midclavicular line

Learning Objectives

1. Recognize when an adult has an immediate life-threatening condition
2. Learn to employ a systematic approach to a critically ill trauma patient
3. Create a differential diagnosis for shock in the setting of penetrating trauma
4. Identify pericardial tamponade and performance of a pericardiocentesis

Critical Actions

• IV access x2
• Supplemental oxygen
• Telemetry monitoring
• Patient history
• Physical exam
• Ask for crash cart
• EKG
• CXR
• Ultrasound (FAST exam)
• Labs: CBC, coagulation profile, BMP, type and cross, troponin
• Fluid administration
• Pericardiocentesis +/- pericardial window
• Tetanus vaccine
• Reassessment of vitals
• Consults called
• Closed-loop communication
• Summarize case to team and/or consultant

Download the case here.