Unstable Penetrating Chest Trauma

Annotation for Point F

Patients who have documented pericardial tamponade can (rarely) be temporized by ultrasound-guided placement of a pericardial catheter. This is most beneficial in a patient with clinically obvious tamponade, who is not yet intubated, to avoid acute decompensation on induction.23 Pericardial drainage should never be performed as a ‘‘diagnostic’’ maneuver and mandates operative exploration, as does the presence of clinical tamponade.15