thoracotomy with pericardial drainage

11 Oct

came across this nice tidbit at resus.me:

 

 

highlights:

you have sick patient you think has cardiac tamponade

this patient probably has a problem on the right side of their heart (e.g. recent procedure, like an ablation)

pericardiocentesis doesn’t work (e.g. clotted blood in this case)

be a bada$$ and do a left-lateral thoracotomy…BUT…

instead of slicing the whole pericardium apart (since the problem to fix is on the other side), make a hole, let it drain, solve the tamponade

flood with blood (transfuse), call a surgeon stat.

 

Sounds cool, hope I never have cause to consider it. But someone did it once, at least. which is kind of cool.

 

References: http://resusme.em.extrememember.com/?p=7058; picture

 

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