A 40 year old male brought to the emergency room with a stab injury to the chest.On examination pt is found to be hemodynamically stable. The neck veins are engorged and the hea sounds are muffled .The following statements are true for this pt except

A 40 year old male brought to the emergency room with a stab injury to the chest.On examination pt is found to be hemodynamically stable. The neck veins are engorged and the hea sounds are muffled .The following statements are true for this pt except –

A. Cardiac tamponade is likely to be present

B. Echocardiogram should be done to rule out pericardial blood

C. Entry wound should be sealed with occlusive dressing

D. Emergency thoracotomy should be done

Correct Answer: Emergency thoracotomy should be done

Description: Pericardial tamponade Pericardial tamponade must be differentiated from tension pneumothorax in the shocked patient with distented neck veins It is most commonly the result of penetrating trauma. Characterized by Beck's Triad (MDH) : Muffled hea sounds, distended neck veins & Hypotension Diagnosis Chest X-Ray : Enlarged hea shadow Echocardiography : ECHO is diagnostic showing fluid in the pericardial sac. Central line : Rising central venous pressure Treatment Needle pericardiocentesis can buy enough time to move to the operating room. Treatment of choice : Surgical pericardiotomy Ref: Sabiston 20th edition Pgno :1678

Category: Surgery

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