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Cardiac tamponade after dialysis catheter insertion — RCPSC EM MCQ

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HardCardiovascular emergenciesCardiac tamponade after dialysis catheter insertionRCPSC EM

CTAS 1: A 54-year-old becomes hypotensive two hours after right internal jugular dialysis catheter placement. Vitals are BP 72/48, HR 128, SpO2 94%. He has distended neck veins, muffled heart sounds and pulsus paradoxus. POCUS shows a large pericardial effusion with right ventricular diastolic collapse. What is the most appropriate next step?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Perform urgent ultrasound-guided pericardiocentesis

Obstructive shock with tamponade physiology requires immediate drainage while resuscitation and cardiothoracic consultation proceed.

Reference: ACLS periarrest care; CAEP POCUS education; Royal College EM Objectives