title: The technique of pericardiocentesis. When to perform it and how to minimize complications.
abstract: Pericardiocentesis is primarily indicated for the management of emergent cardiac tamponade. Insert the needle into the left xiphocostal angle perpendicular to the skin and 3 to 4 mm below the left costal margin (the preferred approach); advance it 5 to 10 mm (or more if necessary) until it reaches the pericardial fluid. A "giving" sensation indicates penetration of the parietal pericardium; a "ticking" one, needle contact with the heart. The needle's position may be confirmed with two-dimensional echocardiography or fluoroscopy. Use the Seldinger technique to insert a catheter for fluid drainage. Monitor the patient continuously for recurrent tamponade, which may result from catheter blockage or fluid reaccumulation.
authors.affiliation: Saint Vincent Hospital, Worcester, Massachusetts, USA.
authors.forename: D H
authors.initials: DH
authors.lastname: Spodick
mesh_terms: D002305:Cardiac Tamponade / Q000628:therapy; D000075202:Contraindications; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D010496:Pericardium; D011677:Punctures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*