(Verse 1) Tones hit hard—“chest pain, trauma,” we roll code three Rain on the windshield, low visibility Walk in, something’s off, room feels tight Patient sitting upright, fighting for life Neck veins bulging like they’re gonna explode Hands on the chest like a crushing load Skin’s pale, cool, diaphoretic dread I hear faint heart tones—barely there instead Pressure’s dropping, systolic slipping away Pulse is thready, tachycardia on display Lungs are clear, but something ain’t right This ain’t tension pneumo… not tonight (Pre-Chorus) That gut feeling hits—yeah, the kind you don’t ignore The kind that spikes the pucker factor to the core (Chorus) Beck’s triad staring me down in the dark JVD, muffled tones, hypotension’s mark Tamponade building, pressure in the sac Every beat’s a battle and it’s not coming back Load and go, no time to stall When the heart can’t fill, it can’t pump at all (Verse 2) History from bystanders—recent chest hit Blunt force trauma, now they’re circling it Electrical alternans dancing on the screen QRS amplitude shifting in between Respirations fast but the lungs stay clear No wheezes, no crackles—just rising fear MAP’s tanking, brain’s losing flow This pressure around the heart’s the silent blow (Bridge – Recognition) Three signs you don’t miss if you know the game: Jugular veins distended, pressure in the frame Muffled heart sounds, like they’re fading away Hypotension crashing harder by the second you stay (Breakdown – Treatment) Oxygen high-flow, keep it tight Two large-bore IVs, fluids wide open, fight We can’t fix the sac in the back of the truck But we can buy them time with a little bit of luck Careful with pressure—don’t drop preload They need that volume to carry the load No delay, no scene time, move with intent Closest trauma center, that’s where they’re sent If they code? That’s the nightmare call Needle in the pericardium—hail Mary for all Rare in the field, but you better be ready Hands don’t shake—keep them steady (Chorus) Beck’s triad staring me down in the dark JVD, muffled tones, hypotension’s mark Tamponade building, pressure in the sac Every beat’s a battle and it’s not coming back Load and go, no time to stall When the heart can’t fill, it can’t pump at all (Outro) We hit the bay, give report, step aside Surgeons rush in, crack chest wide Another call where seconds decide And that pucker factor? Yeah… it never lied.
