Procedure
- subxiphoid approach
- long 18-22 G needle attached to syringe
- insertion: between xiphisternum and left costal margin
- direct towards the left shoulder at 40 degree angle to skin
- continual aspiration as needle approaches RV
- once pericardial fluid aspirated, can insert cannula into pericardial space
- attach a 3 way tap and remove fluid with improvement in haemodynamics