No preparation is required other than that of performing a thoracotomy and a pericardiotomy (Chapter 42). The patient should be intubated, ventilated with 100% oxygen, and fully monitored (i.e., telemetry, a noninvasive blood pressure cuff, and pulse oximetry). Insert a nasogastric tube. Instruct a nurse to administer intravenous broad-spectrum antibiotics that cover skin flora, gram-positive organisms, and gram-negative organisms. The Emergency Physician should wear full personal protective equipment to protect themselves from contact with the patient's blood and body fluids. While time is of the essence and this is an emergent procedure, aseptic technique should be followed.