78F presented with abdominal pain, likely from the hepatic and enteric congestion due to her pre-tamponade state! See thinkingcriticalcare.com for more ultrasound clips and clinical story.
The clip shows first infiltration with local anasthetic along the planned trajectory of puncture as determined by ultrasound as the shortest route. Next, an introducer needle punctures the pericardial sac under direct ultrasound guidance, and bloody pericardial fluid is aspirated. A guidewire is introduced, the needle removed and the position within the pericardium confirmed. Following dilation, a pigtail catheter is inserted and drainage pf the paricardial effusion is performed.