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Question:
You are treating a 24-year-old female with a gunshot wound to the right side of the back. No exit wound is visible. She is awake but confused. Her skin is pale and diaphoretic with cyanosis noted to the oral mucosa. Breath sounds are clear and equal bilaterally. Jugular vein distention is present. Blood pressure is 90/78 mmHg, heart rate is 124 beats per minute, and respiratory rate is 28 per minute and labored. Sinus tachycardia is seen on the cardiac monitor. What condition do you think is most likely present with this patient?
A
Pericardial tamponade
explanation
Pericardial tamponade causes decreased cardiac output as seen by pale skin and hypotension. In addition, jugular vein distention may be seen along with a narrowed pulse pressure. Other signs and symptoms include tachycardia, respiratory difficulties, and cyanosis of the face, neck, and arms. With tension pneumothorax or a significant hemothorax, decreased or absent breath sounds will be present.
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