Pericardiocentesis

[AAFLTMEDIC at aol.com]

Brian,
     Could you tell us what you mean by "fairly successful." My experiences in both pre- and in-hospital care are fairly extensive and I have rarely seen a patient that has needed this procedure. When needed, I have not seen a single good outcome when the procedure was done as a part of a trauma patients care pre-hospital or during the immediate trauma resuscitation. In my experiences, even when the procedure was done as part of a traumatic arrest protocol, there has either been no return of blood presumed from the pericardium or despite this assumed reduction of tamponade, the patient had other severe injuries that precluded succesful resuscitation.
     That said, I did have a patient once about 12 years ago that suffered a single stab wound to the chest from an ice pick who died in the ambulance. I wish that I had been able to attempt a pericarciocentesis on that patient, but I have no idea if the outcome would have been any different.
     Additionally, I assume that your protocols exclude medical patients?

Thanks for your feedback.

Chris Poulsen