Procedural Guidance Step 1, Part 3 » Department of Anesthesiology » College of Medicine

1. What is the preferred location for draining pericardial fluid?*
- A. No preferred, wherever the fluid is closest to the skin and largest amount as to avoid injury to vital organs
- B. Always must be done subxiphoid/subcostal
- C. Always must be done at the apical view
- D. Must be done with ECG monitoring electrodes on tapping needle
2. What structure can you use to differentiate between a pericardial effusion and a left pleural effusion?*
- A. Pericardium
- B. Pleural line
- C. Descending aorta
- D. Lung line
3. T or F: Evaluation of the pericardium is part of the FAST evaluation:*
- A. True
- B. False
4. To differentiate between pericardial effusion and epicardial fat pad, you can use the following except:*
- A. Fat pad moves with the epicardium each heartbeat
- B. Pericardial effusion is usually more hypoechoic or anechoic
- C. Fat pad is seen mostly posteriorly
- D. Fat pad is usually a granular appearance
5. When a pericardial effusion is present, what is the next most important step for the ICU physician?*
- A. Obtain equipment to perform pericardiocentesis
- B. Obtain views to assess LV function
- C. Obtain views to assess for tamponade physiology (RV diastolic collapse)
- D. Call the on call cardiologist