A 24-year-old is stabbed in the left chest. He is pale, heart rate is 132/min and systolic blood pressure is 78 mmHg. FAST shows a pericardial

Question

A 24-year-old is stabbed in the left chest. He is pale, heart rate is 132/min and systolic blood pressure is 78 mmHg. FAST shows a pericardial effusion, JVP is elevated and breath sounds are equal bilaterally. What is the most appropriate initial management?

Accepted Answer

Activate trauma surgery for immediate operative management while temporising with resuscitation and pericardiocentesis if arrest is imminent

Answer

Place a pelvic binder and obtain pelvic radiographs

Answer

Give IV diuretics for cardiogenic pulmonary oedema

Answer

Observe until a formal echocardiogram is available

Answer

Discharge after wound closure if repeat vitals improve

Penetrating cardiac injury with tamponade — RCPSC EM MCQ

A 24-year-old is stabbed in the left chest. He is pale, heart rate is 132/min and systolic blood pressure is 78 mmHg. FAST shows a pericardial effusion, JVP is elevated and breath sounds are equal bilaterally. What is the most appropriate initial management?