Radek Uher, MD Lieutenant colonel, Chief of the 6th Field Hospital / 6th Medical Battalion of the Military Health Agency of the Czech Armed Forces Physician of the Olomouc University Hospital, Emergency and Clinic of anaesthesiology, resuscitation and intensive medicine, Czech Republic Physician of the Emergency Medical Service of the Olomouc Region, Czech Republic
Acute cardiac tamponade is in our country a relatively rare but potentially malignant diagnosis, which can be reversible with proper urgent diagnosis and therapy. It is one of the 4T, but we must think of it not only in the case of a sudden cardiac arrest, but also in all penetrating and blunt (non-penetrating) chest injuries and not only in them. Cardiac tamponade is a dynamic process that evolves in time and the algorithm correctly demonstrates the typical course from the possible cause, the onset of clinical symptoms to severe instability just before cardiac arrest. This is followed by proper diagnosis and therapy leading to stabilization and the recommendation of the aftercare. In individual parts of the algorithm, the whole problematics is summarized step by step, including other useful information. Incorrect answers demonstrate the most common mistakes and decision-making difficulties for this diagnosis. The algorithm correctly emphasizes the key importance of ultrasonography in early hospital care, but it can also be applied to pre-hospital care in case of the availability of ultrasound, which will (hopefully) be the standard in a few years. The mentioned algorithm is a valuable, clear and entertaining professional contribution to the reminder of one potentially reversible cause of a circulatory instability for traumas (or even of a sudden cardiac arrest), including its solution.
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