A 25 yr old man came to emergency depament after A. On CXR, multiple ribs fractures were visible. On physical examination, blood pressure was 80/60 mmHg and hea rate 150/min. Patient was restless, and tachypneic with jugular veins distended. On auscultation, air entry equal on both sides, hea sounds very soft or inaudible. What is the immediate step of management?
Needle inseion in 5th ICS Echo guided Pericardiocentesis Intercostal tube drainage on both sides IV fluids for Hypotension