Prehospital Trauma Life Support (PHTLS) Practice Test

In which situation is pericardial tamponade most likely to occur?

1. Stab wound to the chest

2. Fall from a height

3. Frontal impact vehicle crash

4. Gunshot wound to the chest

The correct answer is: Stab wound to the chest

Pericardial tamponade is a clinical condition that arises when fluid accumulates in the pericardial sac, exerting pressure on the heart and impairing its ability to pump efficiently. In the context of traumatic injuries, this condition is most commonly associated with penetrating trauma, especially injuries caused by sharp objects. Stab wounds to the chest can cause direct injury to the heart or major blood vessels, leading to rapid accumulation of blood in the pericardial space. This accumulation can occur acutely and can be life-threatening, as the pericardium can become distended enough to restrict the heart's function. Quick recognition and management are critical in this scenario, making stab wounds to the chest a classic case for pericardial tamponade. In contrast, although gunshot wounds to the chest can also result in pericardial tamponade, they may produce different wounds and mechanisms depending on the trajectory and type of bullet. Similarly, falls from heights and frontal vehicle crashes may lead to thoracic injuries but are less directly associated with the swift development of tamponade compared to a stab wound. Each of these situations can indeed cause cardiac injury, but the specific mechanism and presentation with stab wounds make it the most likely scenario for peric