When there is an inability to perform pericardial tamponade, what does the working guideline suggest?

The correct approach in this scenario is to try additional fluids. In the context of pericardial tamponade, it is essential to manage hemodynamic stability as quickly as possible. Administering additional fluids can help in increasing venous return and, in turn, may improve cardiac output temporarily. This can be crucial in patients who do not respond to initial treatments and need stabilization before definitive surgical intervention can occur.

While options like performing a drainage procedure and immediate transfer to surgery are also important considerations in cases of pericardial tamponade, these actions might not be feasible due to various clinical circumstances or resource limitations. Additionally, administering pain medication may alleviate discomfort but does not address the underlying issue of tamponade physiology. Therefore, trying additional fluids is a pragmatic approach to stabilize the patient while further intervention is planned or arranged.