Resuscitation (2008) 76, 146—148 available at www.sciencedirect.com journal homepage: www.elsevier.com/locate/resuscitation CASE REPORT Prehospital ultrasound detects pericardial tamponade in a pregnant victim of stabbing assault  Christian Byhahn a,* , Tobias M. Bingold a , Bernhard Zwissler a , Marcus Maier b , Felix Walcher b a Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, J.W. Goethe-University Medical School, Frankfurt/M, Germany b Department of Trauma Surgery, J.W. Goethe-University Medical School, Frankfurt/M, Germany Received 10 April 2007; received in revised form 25 June 2007; accepted 4 July 2007 KEYWORDS Pericardial tamponade; Emergency treatment; Trauma Summary The development of handheld, portable ultrasound devices has enabled the use of this diagnostic tool also in the out-of-hospital environment. We report on a pregnant teenager who was found haemodynamically unstable after a stab assault. When she suffered cardiac arrest shortly thereafter, diagnosis of cardiac tamponade was made by portable ultrasound, and immediate pericardiocentesis was performed by the emergency physician. While her baby died after emergency Caesarean section, the teenager survived after thoracotomy and prolonged resuscitation without neurological sequelae. © 2007 Elsevier Ireland Ltd. All rights reserved. Case report An emergency medical technician unit and a physician- staffed ambulance were dispatched simultaneously to an apartment when a caller to the police reported that he just stabbed his girlfriend multiple times. Six minutes later both units arrived at the scene. The emergency physician, a board-certified anaesthesiologist and intensivist, found a  A Spanish translated version of the summary of this arti- cle appears as Appendix in the final online version at 10.1016/j.resuscitation.2007.07.020. ∗ Corresponding author. Tel.: +49 69 6301 5513; fax: +49 69 6301 5881. E-mail address: c.byhahn@em.uni-frankfurt.de (C. Byhahn). 17-year-old girl unresponsive (Glasgow Coma Scale score 7) and in severe shock. A bystander reported her to be pregnant in the 26th week of gestation. The injury pattern consisted of multiple stab wounds to the left hemithorax, three stab wounds to the upper abdomen, and some superfi- cial cuts to the left cervical region. While no blood pressure could be recorded, the patient’s carotid pulse was weak, but palpable. The initial 3-lead ECG showed supraventricular tachycardia. After two large-bore IV lines were inserted into the cubital veins and fluid resuscitation started, the patient’s trachea was intubated uneventfully, and a chest tube was inserted into the left thoracic cavity, immediately evacu- ating air and approximately 800 mL of blood. Despite these measures and continued aggressive fluid resuscitation, the patient’s vital signs declined to pulseless electrical activity 0300-9572/$ — see front matter © 2007 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.resuscitation.2007.07.020