350.During a bar fight a client was punctured with an ice pick. He is
brought to the emergency room because he can nolonger walk due to
weakness, and he is feeling faint. You place him on oxygen as you listen to
his heart and lungs. All his heart sounds are distant and muffled and his
blood pressure is low despite a very rapid pulse. His lungs sound normal.
Using a 3 in. 19 gauge needle you do which of the following?
a. Insert it just under the left tip of the xiphoid process in an effort to remove
blood from the pericardial cavity
b. Insert it at the second intercostal space on the left side of the sternum in an
effort to inject nitroglycerine in an effort to increase the strength of cardiac
contractions.
c. Insert it at the ninth intercostal space at the left midclavicular line in an effort
to remove blood from the pleural cavity
d. Insert it at the fourth intercostal space on the right side in an effort to remove
blood from the right pulmonary artery
e. Insert it just under the left clavicle in an effort to remove blood from the right
cephalic vein
468 Anatomy, Histology, and Cell Biology