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#Pericardiocentesis Site of Puncture;

There are 3 Options .

1.Subxiphoid
2.Parasternal
3.Apical

Factors to choose site .

•It depends on location ,type (eg circumferential)

•In situation of cardiac arrest or emergency situation ,subxiphoid is best . Image
For other situations ,Apical is safest when performed under ultrasound guidance with biopsy line function of probe.

•Choose the location with probe with biopsy line ,avoiding any parallel structure (heart,liver,lung)
Puncture Canal or Axis .

If needle has long puncture Canal /axis in effusion it is safe .

1.Subxiphoid Approach;

•Puncture is always directed towards right heart so short part of Puncture axis within effusion

•subxiphoid puncture often passes through liver.
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