Pericardiocentesis

INDICATION

          Cardiac tampon

EQUIPMENT

• local unaesthetic
• # 16 (orange) or # 18 (green) intravenous over the needle catheter, connected to a 20 ml syringe
• a three way stopcock

SITE OF PLACEMENT

          1-2 cm to the left of the sternum in the left hypochondriac

PROCEDURE

• surgically prepare and drape the puncture site and infiltrate with local anesthetic
• insert the needle through the skin at the puncture site and advance the needle forward aiming towards the lower tip of the left scapula, while pulling out the plunger of the syringe to apply suction.
• Aspirate as much blood as possible from the pericardia sac
• Remove the needle and syringe leaving the catheter in sit and securing it to the skin with plaster.
• Connect the 3 way stopcock (in the closed position) to the catheter for respiration purposes, in case cardiac tampon develops again.

POSSIBLE COMPLICATIONS

• Local cellulitis / stomachache
• Puncturing of :

• myocardium leading to possible ventricular fibrillation; ECG monitoring is advised
• coronary artery or vein, possibly leading to a new pericardium
• lung with possible chemotherapy
• intercontinental or great medicinal vessels with possible chemotherapy
• esophagus with possible tendinitis
• peritoneum with possible peritonitis