Traumatic cardiac tamponade is most commonly caused from penetrating cardiac injury however may develop with blunt chest trauma.
As the pericardial sac fills with blood, the heart’s ability to pump is compromised with a subsequent drop in cardiac output. The patient will become progressively more shocked eventually leading to cardiac arrest.
- raised JVP*
- muffed heart sounds*
*can be difficult to elicit these signs reliably in a trauma patient
Ultrasound (eFAST) is the most sensitive diagnostic modality and should be performed as part of the primary survey in shocked patients with suspected tamponade
Urgent thoracotomy is required for patients with traumatic cardiac tamponade
Ideally this should take place in the operating room, however if a patient is periarrest or in cardiac arrest, an ED thoracotomy needs to be considered
Needle pericardiocentesis may provide brief decompression of tamponade (provided the blood has not clotted), however this is a temporising measure only.
Disposition – interhospital transfer guidelinescardiac tamponade destination v2
About this guideline
Published: February 2018
Author: Emma Batistich
Approved by: Northern Region Trauma Network, ADHB, WDHB, CMDHB, NDHB
Review due: 2 years