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The surgical, operative, nursing and anaesthesiology staff most capable and best trained to perform the procedure are often not immediately available, requiring emergency medical staff to perform this life\u2010saving intervention. When tamponade causes refractory shock or peri\u2010arrest, left anterolateral thoracotomy remains the preferred technique for definitive pericardial decompression, with extension to a clamshell thoracotomy when required.<\/jats:p>","DOI":"10.1111\/1742-6723.70328","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T02:36:47Z","timestamp":1786329407000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pericardial Decompression for Acute Traumatic Cardiac Tamponade\u2014Pearls and Clamshells"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0183-7761","authenticated-orcid":false,"given":"Mark","family":"Fitzgerald","sequence":"first","affiliation":[{"name":"Trauma Service The Alfred Hospital  Melbourne Australia"},{"name":"National Trauma Research Institute  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6356-7045","authenticated-orcid":false,"given":"Cecil","family":"Johnny","sequence":"additional","affiliation":[{"name":"Trauma Service The Alfred Hospital  Melbourne Australia"},{"name":"National Trauma Research Institute  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8901-4027","authenticated-orcid":false,"given":"Chen","family":"Lew","sequence":"additional","affiliation":[{"name":"Trauma Service The Alfred Hospital  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7324-8088","authenticated-orcid":false,"given":"Jeremy","family":"Hsu","sequence":"additional","affiliation":[{"name":"Trauma Service Westmead Hospital  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2336-1525","authenticated-orcid":false,"given":"Christopher","family":"Groombridge","sequence":"additional","affiliation":[{"name":"Trauma Service The Alfred Hospital  Melbourne Australia"},{"name":"National Trauma Research Institute  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2394-682X","authenticated-orcid":false,"given":"Joseph","family":"Mathew","sequence":"additional","affiliation":[{"name":"Trauma Service The Alfred Hospital  Melbourne Australia"},{"name":"National Trauma Research Institute  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8696-6595","authenticated-orcid":false,"given":"Malinda","family":"Weerasinghe","sequence":"additional","affiliation":[{"name":"Trauma Service The Alfred Hospital  Melbourne Australia"},{"name":"National Trauma Research Institute  Melbourne Australia"},{"name":"Emergency Service Dandenong Hospital  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7826-0986","authenticated-orcid":false,"given":"Silvana","family":"Morasco","sequence":"additional","affiliation":[{"name":"Cardiothoracic Surgery The Alfred Hospital  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,9]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"M\u00e9moires de chirurgie militaire et campagne","author":"Larrey D. 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