Cardiac tamponade

Question 1

Which part of A-E does this affect

Answer 1

Circulation

Question 2

Airway

Answer 2

Question 3

Breathing

Answer 3

Look for increased respiratory effort

Listen for vesicular chest sounds

Feel for chest expansion and percuss

Obs: O2 and RR

Ix: ABG (lactate) and CXR (globular heart)

Question 4

Circulation

Answer 4

Look for any signs of hypervolaemia i.e. raised JVP, oedema, raised JVP on inspiration (Kaussmal sign)

Listen for muffled heart sounds (Beck’s triad: hypotension, JVP, muffled sounds)

Feel for pulse: pulsus paradoxus (pulse fails on inspiration)

Obs: HR, BP: hypotension

Ix:
1. Take bloods: FBC, U&Es, LFTs, BNP, troponin, D-dimer, Clotting, G&S, CRP, cholesterol, glucose, lipids

2. Cannulate
3. ECG: electrical alternans (low voltages)
4. Echo

Question 5

D & E

Answer 5

make sure to put catheter to monitor UO, and also do a fluid diary for fluid status

Question 6

Management

Answer 6