d. Pericardial Tamponade. Pericardial tamponade is caused by blood or
other fluid accumulating in the pericardial sac that surrounds the heart. The fluid
compresses the heart and interferes with its function. Pericardial tamponade is a life-
threatening condition that requires respiratory support and immediate evacuation.
Signs and symptoms of pericardial tamponade include the following.
Very soft, faint heart sounds, which may be hard to hear even with a
Congested and distended veins in the head and neck.
Difficulty in breathing.
Tachycardia (weak and rapid pulse).
(5) Rapidly decreasing blood pressure with the systolic and diastolic
readings coming closer and closer together.
The major differentiating factor between a tension pneumothorax and the
pericardial tamponade is the presence or absence of breath sounds. In
pericardial tamponade, the patient would still have equal and bi-lateral
e. Massive Internal Bleeding. Injury to the great blood vessels located within
the chest can cause a rapid loss of blood. The casualty will show signs and symptoms
of hypovolemic shock.
f. Laceration of a Major Airway. Injury to the trachea or bronchi can result in
tension pneumothorax, hemoptysis (coughing up blood), and respiratory distress.
Provide respirator support and evacuate the casualty. This patient will need
immediate aggressive airway support that may not be feasible even during tactical
g. Abdominal Injuries. Injuries to the lower ribs may indicate abdominal
injuries, such as damage to the kidneys.