Pericardialtamponadeinblunttraumashouldbecon- sideredasurgicaldiseaseandrequiresdirectopenexplo- rationoftheinjury.Icommendtheauthorsonsuccessful resuscitation within their area of clinical expertise and comfort.However,Ibelievethatthefurthermanagement ofthispatientwassuboptimalandshouldnotbeconsid- eredstandardpractice.Thiscasealsohighlightstheneed for the development of a paediatric trauma system in Singapore if one is not already in place.