Pericardial Tamponade is a medical condition in which the work of the heart is compromised by a fluid build up in the pericardium. The pericardium is the sac in which encloses the heart. Once this fluid, which is most often blood due to some sort of penetrating or blunt force trauma, has entered the pericardium it stretches the sac more than it can stretch then tamponade occurs. Tamponade is a closure or blockage and in some cases this is very beneficial, especially pertaining to a wound to stop hemorrhaging from continuing. In the case of pericardial tamponade it is not beneficial. This type of blockage is the result of the heart not able to function properly due to the excess fluid thus resulting in the reduction of the amount of blood circulating through the body.
Our blood circulates through our body carrying vital components to and from cells, organs, and tissues of the body. Some of these components are of course the blood itself, platelets, red blood cells, white blood cells, and also oxygen. This is just the tip of what the blood carries to important destinations within our body. If these components are not reaching their destinations due to tamponade then we will not get adequate oxygen, be able to fight off infections and have the energy we need. Blood also carries away waste products.
Some of the signs and symptoms of Pericardial Tamponade are engorged neck veins or jugular vein distention which is an indicator that there is extreme pressure in the right atrium or blood flow from the right atrium to the right ventricle is compromised. Other signs and symptoms are a decrease in blood pressure, muffled heart sounds, and tachycardia. Keep in mind these signs and symptoms may not all be there right away. Further assessment should be completed by a physician or doctor at a hospital where the patient can receive definitive care.
In the pre-hospital care setting, we are limited to what we can do in order to get a viable patient to the hospital. Trained professionals can administer oxygen, fluids and initiate treatment for shock. Rapid transport to the closest facility in which can handle this type of emergency is of the utmost importance. Once at the receiving facility, definitive care can be given in which cannot be given in the field or pre-hospital settings. Be prepared for the transport to the facility in case further complications arise from the pericardial tamponade such as cardiac arrest and or a stroke.
Once at the receiving facility, steps can be taken to relieve the pericardium of the fluid. This can be done by inserting a needle through the fifth intercostal space and aspirating fluid. This procedure should only be done by trained professionals as they will most likely be guided by an ultrasound during the procedure. A cannula is most often placed in and left in case the draining procedure is needed to be done again. With pericardial tamponade you can have a positive outcome. However, this is dependent on the time it takes to notify the proper individuals of the situation and get the patient to the receiving facility. If left untreated or diagnosed, death is a likely condition.