Thread by @EM_RESUS

Here’s an Echo of a man who was in persistent PEA after multiple rounds of CPR per ACLS

You can see his heart collapsing and struggling to beat as it is being smothered by surrounding fluid.

This is Pericardial Tamponade!

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Once you have diagnosed a coding patient with Pericardial Tamponade you have 2 options:

A) You can keep doing ACLS for a while and then call the code

B) You can remove pericardial fluid and save your patient’s life

2/x

If you look closely at the video clip you can see a needle tip entering the effusion in the pericardial space above the heart.

15 mLs of fluid was removed using an 18G needle and the patient instantly regained pulses!

3/x

Here’s what his Echo looked like after the procedure:

You can see that the effusion is smaller, his right heart is no longer collapsing, and there is now much more blood coming around to fill his left ventricle.

4/x

Without Echo no one would have ever figured out this man was in Tamponade. He would have gotten standard ACLS for some time and then ultimately would have been pronounced dead.

This is why Echo saves lives.

#FOAMed

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