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VNs are able to carry out TFAST scans if they are trained and confident in performing the procedure.
Figure 2. A normal ECG complex and a ventricular premature complex( VPC) [ 16 ].
Post procedure
The patient should be kept in the intensive care unit, and general nursing care should be provided to reduce the risk of preventable pain or discomfort while in hospital. This includes recumbency care and urinary bladder management [ 18 ]. A urinary catheter can be placed to reduce the risk of urine scalding and allow the VN to calculate the patient ' s fluid output, the results of which would help the VS to alter the treatment plan accordingly.
Facilitating intensive one-to-one nursing directly after the procedure will allow the VN to observe the patient closely and monitor for signs such as respiratory distress, the development of ascites or any other clinical signs that would indicate the effusion has returned. The patient should be connected to an ECG machine to monitor for any cardiac abnormalities, disturbances or arrhythmias [ 19 ].
Supplying the patient with supplementary O 2 while hospitalised will limit the risk of hypoxia / hypoxaemia, thus reducing the risk of long-term organ damage or failure [ 20 ]. Care must be taken when providing O 2 as it should be done in a way that causes the least amount of stress. If the animal is constantly moving and trying to paw nasal prongs away from their face, then flow-by
O 2 therapy should be provided instead. If this still causes the patient anxiety, then the use of an oxygen tent might be necessary.
The patient ' s BP should be monitored, as this will give an indication of cardiac output. If the animal is hypotensive or hypertensive, medications or bolus fluids should be given to correct the BP, under the direction of the VS. In principle, the patient may have presented hypotensive, but the pericardiocentesis will allow the bodily functions to return to normal and the stroke volume to increase. This should result in normotension unless there is an undiagnosed or underlying condition [ 21 ].
Additional diagnostic investigations such as further imaging may be warranted after the procedure. For example, if the animal becomes acutely tachycardic, a thoracic focused assessment with sonography for trauma( TFAST) scan can be carried out and repeated every 4 – 8 hours, or immediately if the patient ' s condition deteriorates. It is quick to perform and can be done on the conscious animal if they are amenable [ 22 ].
Radiography may also be necessary to assess the extent of the pericardial effusion and would be the second imaging option. Radiographs often show an increase in the size of the cardiac silhouette, which generally is globoid in appearance in these cases [ 23 ]. If the animal is lethargic or‘ flat’, radiography can be done with the patient conscious. Radiographs taken after pericardiocentesis may also show if any organs were damaged during the procedure.
In practices where this is available, a computed tomography( CT) scan can be performed if the patient continues to show signs of a pericardial effusion despite it having been drained. This will provide more accurate detail of the location, extent and volume of the effusion [ 24 ]. The animal will need to be heavily sedated or placed under general anaesthesia for CT, so the method is not commonly the first choice for imaging. However, a CT scan may help to distinguish what is causing the pericardial effusion, and a medical or surgical plan can then be developed to treat the underlying condition.
Conclusions
Pericardial effusion and cardiac tamponade are emergencies requiring swift diagnosis and intervention to improve the likelihood of patient survival. Performing pericardiocentesis will provide immediate relief by the physical drainage of the excess fluid compressing the heart. The removal of this fluid allows the cardiac output to be restored, thus reducing the clinical signs.
Best practice in technique and monitoring before, during and after pericardiocentesis are essential to optimise the outcomes and minimise the risks of complications such as arrhythmias, haemorrhage or infection.
Providing pre-emptive analgesia will reduce the risk of wind-up, and current best practice monitoring will allow rapid provision of pain relief as required by the animal. A detailed care plan should be created for each patient by the VS in cooperation with the VN.
Ultimately, expert nursing care – combined with advanced diagnostic techniques, effective communication and vigilant teamwork – forms the foundation for successful management and patient recovery in cases of pericardial effusion and cardiac tamponade.
Volume 41( 2) • April 2026
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