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If diathermy is expected near the pericardium, the patient is at risk of VF. Consider placing defibrillation pads on prior to prepping patient

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Feb 25, 2012
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There is a risk of circulatory collapse and or pulmonary edema following relief of the tamponade.
Ensure vasopressors and inotropes are drawn up prior to induction.

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Look at transthoracic echo to gauge degree of stroke volume compromise.

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Ensure vasopressors and inotropes are drawn up prior to induction

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Jun 15, 2011
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If to be done under general anaesthesia GA, surgeon to be scrubbed & patient prepped prior to induction

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May 18, 2011
Communicate closely with surgeon to ensure they are aware the patient is still awake despite being prepped.
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Ketamine may be useful induction agent to maintain sympathetic tone if performing this under general anaesthesia.

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Aug 13, 2012
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Local anesthetic infiltration under sedation for pericardiocentesis reduces risk of haemodynamic instability that may be experienced with a GA

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Avoid drugs or physiological changes (acidodis) that cause myocardial depression

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Jun 15, 2011
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Beck's triad (hypotension, distended neck veins, muffled heart sounds)

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Jun 10, 2011
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Consider pretreatment with atropine to prevent bradycardia

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May 18, 2011
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Maintain high normal heart rate to maintain adequate cardiac output in the context of a reduced stroke volume.

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Feb 25, 2012
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Maintain high normal preload to promote ventricular filling in the context of reduced ventricular compliance.

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Stroke volume is relatively fixed. Cardiac output dependent on heart rate.

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May 18, 2011
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Ensure the patient is admitted to a monitored bed if a pericardial drain is in situ as they will be at risk of arrythmias from myocardial irritation #safety

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