Pericardiocentesis for MRCEM
Note the RCEM page, which basically says "don't do it unless genuinely no one can open the chest". It's a temporising measure! It's like a needle cric! (in that, they are already in trouble)
indication
cardiac tamponade, i.e.
- pericardial effusion AND
- shocked
contraindications
- aortic dissection (i.e. the tamponade is stopping their exsanguination)
- traumatic pericardial effusion
landmarks
between xiphisternum and left costal margin at a 30ยบ angle to the skin