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View Full Version : Cardiac Tamponade and 12 leads

Epinephrine
05-31-2005, 22:07
So reading a scenario from JEMS...

http://www2.us.elsevierhealth.com/scripts/om.dll/serve?action=searchDB&searchDBfor=art&artType=full&id=as0197251005701224

I know there is Beck's Triad (Narrowing Pulse Pressure, JVD, muffled heart sounds) which will point to Tamponade. I'll give the crew they sound have seen the bandage... however this left me wondering...

The monitor showed Sinus Tach. Would a 12 lead have shown anything? I realise the beats were being conducted through the tissue, but does the excess blood show as ST elevation or something else, or are we just looking at history/story and then Beck's Triad for Tamponade?
RyanEMVFD
06-03-2005, 12:54
The two I've seen didn't show anything really out of the ordinary.

Reading the scenario, I would listened to breath sounds again in the truck since they couldn't hear them in the plant. Other then that, I have to admit I probably would have done the same as them. It would have been nice if the nurse would have been there or had someone remove his shirt to cool him down beforehand.
bayoumedic
06-08-2005, 18:23
How many of us are going to run a 12 lead on a trauma patient? As for my experience most tamponades in the hospital are found with Ct scans and the such. Just my 2 cents.
Nate
06-08-2005, 19:24
How many of us are going to run a 12 lead on a trauma patient? As for my experience most tamponades in the hospital are found with Ct scans and the such. Just my 2 cents.

Me, when the last service I worked for had 12 leads.
Epinephrine
06-08-2005, 22:44
Well knowing after the fact that there was chest trauma and given his symptoms a 3 lead at the least and hopefully a 12 lead could have been run.

I've never actually had or seen a pt with tamponade before so I was just wondering what to expect... Thank you the input. :)
EMSsquirrel
06-09-2005, 01:16
Well, I would like to know why they didn't spot the bandage and ask questions. Now, nobody's perfect, but come on, when you're putting on leads, listening to lung sounds, etc... take a look! Heck, if he was supposed to be that overheated that they're treating him for heat exhaustion, he's getting near nekkid anyway. And am I the only person who does a rapid head-to-toe on almost everyone with a decreased level of consciousness? It's a great thing to do, helps you find things you'd otherwise miss. It's even a good scene safety thing to find those knives/guns/etc.

- Greg