Pericardiocentesis in prehospital settings

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Dear members,

Citing the Liverpool Hospital Trauma Manual, 6th Ed., pericardiocentesis may
be performed if the following criteria are met:
- You are unable to do a thoracotomy.
- A surgeon is not available.
- The patient is in extremis (about to die).
- You have a high degree of suspicion that tamponade is present.

It is in alll the textbooks and in the ATLS course, so a flight or ambulance
physician can legitimately use it. What is reality and your experience?
Does anyone use it in prehospital settings? If yes, what are results?
Is there any evidence supporting the use or non-use of pericardiocentesis
for suspected cardiac tamponade in prehospital settings?

Note, here I am speaking only about decompressive pericardiocentesis in
prehospital settings, not in ED or OT (where it plays no role now, as I
understand).

Thank you,
Alex Oparin, MD
General Surgery
Samara, Russia

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