Ultrasound Guided Pericardiocentesis

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glennpaetow

STAB Conference with Courtney Elm, MD

Santé & Médecine

HENNEPIN COUNTY MEDICAL CENTER
EMERGENCY MEDICINE Every Life Matters
ULTRASOUND GUIDED
PERICARDIOCENTESIS

HENNEPIN COUNTY MEDICAL CENTER
EMERGENCY MEDICINE
Indications and Complications
• Indications = Tamponade
• Complications
– Ventricular or atrial puncture
– Coronary artery injury
– Pneumothorax
– Internal mammillary artery injury
– Rib Neurovascular bundle injury
Every Life Matters

HENNEPIN COUNTY MEDICAL CENTER
EMERGENCY MEDICINE
Dark Ages (Before US)

HENNEPIN COUNTY MEDICAL CENTER
EMERGENCY MEDICINE
Step 1 – Visualize the Effusion
Every Life Matters

HENNEPIN COUNTY MEDICAL CENTER
EMERGENCY MEDICINE
Locations for
Pericardiocentesis
Every Life Matters

HENNEPIN COUNTY MEDICAL CENTER
EMERGENCY MEDICINE
Step 2 – Insert the Needle
To Confirm Placement of the Needle Tip
• Aspirate
• Directly visualize the Needle Tip
• Bubble Test
Every Life Matters

HENNEPIN COUNTY MEDICAL CENTER
EMERGENCY MEDICINE
Bubble Test
Every Life Matters

HENNEPIN COUNTY MEDICAL CENTER
EMERGENCY MEDICINE
Step 3- Place the Guidewire
Every Life Matters

HENNEPIN COUNTY MEDICAL CENTER
EMERGENCY MEDICINE
Step 4 – Place Catheter
Seldinger Technique
Pro Tip: Do not aspirate all the fluid prior to placing
the catheter
Confirm Placement
• Decreased Effusion size
• Improved Hemodynaimcs
Every Life Matters

HENNEPIN COUNTY MEDICAL CENTER
EMERGENCY MEDICINE
Summary
Direct Visualization avoids vital structures
Bubble test to confirm placement

HENNEPIN COUNTY MEDICAL CENTER
EMERGENCY MEDICINE
Thank You – Questions?

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