Cardiac tamponade assessment and management Flashcards
(21 cards)
What are common symptoms reported by a patient with cardiac tamponade?
Shortness of breath, chest tightness, dizziness
Patients may also be too ill to answer questions about their medical history and may show signs of anxiety and restlessness.
In which patients should cardiac tamponade be suspected?
Patients with a penetrating wound of the chest or upper abdomen
Tension pneumothorax is more common, but cardiac tamponade should be considered in these cases.
What medical history might suggest non-traumatic cardiac tamponade?
Pericarditis, end-stage renal disease
These conditions can lead to fluid accumulation in the pericardial space.
How can you differentiate between cardiac tamponade and tension pneumothorax?
Breath sounds are equal and trachea is midline in cardiac tamponade
In tension pneumothorax, breath sounds may be diminished on the affected side.
What is Beck’s triad in relation to cardiac tamponade?
JVD, hypotension, muffled heart sounds
These signs are classic for cardiac tamponade but may be present in less than half of all patients.
What may happen to heart sounds in cardiac tamponade as the condition worsens?
Heart sounds become progressively fainter or muffled
They may be normal early on in the condition.
List other signs of cardiac tamponade.
- Cold, pale, mottled, or cyanotic skin
- Tachycardia
- Weak or absent peripheral pulses
- Narrowing pulse pressure
- Pulsus paradoxus
Pulsus paradoxus is a late sign and may be absent if the patient has severe hypotension.
What symptoms may mimic heart failure in slowly developing cardiac tamponade?
- Dyspnea
- Orthopnea
- JVD
These symptoms can overlap with those of heart failure, complicating diagnosis.
What is the value of ECG in identifying cardiac tamponade?
Of limited value; may show low amplitude QRS complexes, T waves, ST-segment elevation
Nonspecific T-wave changes may also occur.
What is electrical alternans in the context of cardiac tamponade?
P wave, QRS complex, and T wave alternate in amplitude with every other beat
This occurs due to constant motion of the heart within the fluid-filled pericardium.
What is the first step in managing a life-threatening hemorrhage?
Address any life-threatening hemorrhage
This is critical to prevent further complications and stabilize the patient.
What is the target SpO2 level to maintain during treatment?
94% or higher
This is essential for adequate oxygenation and ventilation.
What should be applied to monitor the patient’s oxygen saturation?
Pulse oximeter
This device helps in assessing the oxygenation status of the patient.
What should be avoided during emergency care to ensure timely transport?
Performing additional procedures on the scene
Delays in transport can worsen the patient’s condition.
What type of IV fluid should be administered if the patient shows no signs of heart failure?
Normal saline
This is used to maintain circulating blood volume.
What should be assessed to check the patient’s response to treatment?
Mental status, heart rate, respiratory effort, breath sounds, blood pressure
These parameters help evaluate the effectiveness of the interventions.
What is an important aspect of patient care during treatment?
Explain all procedures and provide emotional support
This helps the patient and family feel informed and supported.
What is the definitive treatment for cardiac tamponade?
In-hospital pericardiocentesis
This procedure involves draining excess fluid from the pericardial space.
How much fluid withdrawal can significantly improve the patient’s condition in cardiac tamponade?
As little as 50 mL
Even small amounts can lead to substantial clinical improvement.
What may be necessary if scarring is the cause of cardiac tamponade?
Surgery to remove the affected area
This addresses the underlying cause of the tamponade.
When reporting to medical control, what should be identified?
All signs and symptoms indicating cardiac tamponade
This ensures the receiving facility is prepared for pericardiocentesis.
