POCUS - Positive EFAST exam with hemopericardium

An adult patient was involved in a high speed motor vehicle collision (MVC) and arrives to the emergency room via EMS. This video demonstrates the positive findings of an E-FAST exam for both hemoperitoneum and hemopericardium.
Recognizing and intervening in hemopericardium can be lifesaving as in this case since it can cause significant hemodynamic compromise.
Learn how to identify this crucial finding during this video.
Author: Jared T Marx MD

[@glory1719]

This presentation is appreciated Sir!

[@drgadham]

EXCELLENT PRESENTATION

[@gabormarkolt2777]

Thank you

[@ArwAHamed]

Thank you sir, for sharing this.

[@joeerwin8687]

Is a pericardiocentesis indicated if awaiting transfer?

[@POCUSGeek]

A pericardiocentesis would have little effect on this. The clotted blood can't be aspirated and would require a thoracotomy. This would be a difficult in a rural setting and would be a pretty heroic measure with poor prognosis in that setting. Best chance of any survival is early recognition, fluids to maintain pressure in the RV and transfer promptly.

[@joestevenson5568]

@@POCUSGeek As you can see some non-clotted fluid in the space would it not be worth attempting to aspirate this? You won't drain everything but surely it could serve as a temporising measure?