Consider CardioThoracic Surgery Consultation. Consider using blood salvage pleuravac for possible reinfusion. Hole in the atrium, ventricle, or intra-pericardial vena cava results in blood loss into the percardial sac. As blood accumulates in pericardial sac, then end diastolic volume is reduced, resulting in a fall of the cardiac output. Hypotension and distended neck veins without a tension pneumothorax.
Distant heart sounds.
Positive pericardial fluid on FAST exam. IV fluid bolus. Pericardiocentesis, or 3. If positive, immediately go to OR for median sternotomy or thoracotomy. Blunt force to the chest.