Introduction: Cardiac tamponade commonly results from penetrating injuries. Blunt trauma may also cause pericardial blood accumulation due to injuries of the heart, great vessels, and pericardial vessels. Most of these signs may be difficult to detect, owing to local conditions during the initial patient assessment and management. Thus, the health care team should always keep its suspition and clinical picture in mind for the correct diagnosis. They should also be prepared for the possible need of immediate performance of pericardiocentesis at the scene of the trauma as well as in the emergency room.

Methods: A case report of a successful pericardiocentesis performed during the pre-hospital trauma care.

Results: The patient was on a tile roof of a building under construction.. He was throuw out of balance after being hit by a thrown tile and fell down on earth ground 33 feet below. During the pre-hospital management Suddenly the oxygen saturation fell, radial pulses became abscent, heart rate rised to 152 bpm (sinusal), SBP was inaudible, and distended neck veins were present. With the diagnostic hypothesis of cardiac tamponade, a pericardiocentesis by the subxyphoid method was performed yielding 25 mL uncoagulated blood. At the Emergency Surgery Service bleeding from the left atrium appendage could be treat.

Conclusion: Although strongly criticized emergency room health teams, pericardiocentesis is still a useful procedure. All emergency health teams should keep in mind the clinical signs of cardiac tamponade in order to safely perform the procedure, even during the pre-hospital care.