First Things First (assess & treat for the following)

• Assess patient.
  • Measure HR, BP, oxygen sat, RR, and temp.
  • Determine if patient is in shock. Are feet warm or cold?
  • If patient is asymptomatic and vitals are stable, continue to watch closely.
  • If in shock or unstable, think “full and fast.”
    • Place large-bore IV.
    • Institute fluids and possibly inotropes while arranging for urgent pericardiocentesis.
  • Invasive monitors (A-line, CVP, PAC)
    • Helpful in managing patient
      • But do not delay life-saving intervention for the patient in extremis in order to place them.