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Penetrating cardiac injury with tamponade — RCPSC EM MCQ

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HardTraumaPenetrating cardiac injury with tamponadeRCPSC EM

A 34-year-old man is stabbed in the left chest and arrives CTAS 1. He is diaphoretic, BP 72/40, HR 148, neck veins are distended, breath sounds are equal, and heart sounds are muffled. FAST shows pericardial fluid. What is the most appropriate next step?

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Correct answer: D — Proceed to urgent operative decompression of traumatic tamponade

Penetrating chest trauma with obstructive shock and pericardial fluid indicates traumatic tamponade. Definitive operative decompression is required; CT is inappropriate in extremis.

Reference: ACLS/ATLS/PALS principles adapted to Canadian ED practice