In suspected cardiac tamponade, point-of-care ultrasound should be used to confirm the diagnosis. （Evidence level:C；Recommendation grade:1).

In the case of cardiac tamponade, we recommend immediate decompression of the pericardium.（Evidence level:C；Recommendation grade:1).

Immediate decompression can be achieved by either ultrasound-guided pericarf diocentesis or, in the case of a haemopericardium, by resuscitative thoracotomy.（Evidence level:C；Recommendation grade:1).

When training for peri-operative cardiac arrest, we suggest a co-ordinated protocol to improve the quality of mechanical cardiopulmonary resuscitation.（Evidence level:C；Recommendation grade:2).

We suggest simulation training as experience and training of healthcare providers increases the likelihood of return of spontaneous circulation.（Evidence level:C；Recommendation grade:2).

We recommend that sedation providers should tailor the doses dependent on patient factors, procedure type and duration, and complexity（Evidence level:Moderate；Recommendation grade:Strong).

We recommend the provision of inhalational agents to provide the patient with an alternative to sedation.（Evidence level:Moderate；Recommendation grade:Strong).

We recommend that patients receive comprehensive information about what to expect from the sedation and sensory experience of the procedure.（Evidence level: High；Recommendation grade:Strong).

We recommend that patients are involved in shared decision-making, where possible, when choosing which sedative medication (if any) to proceed with during an endoscopic procedure.（Evidence level: Low；Recommendation grade:Strong).

We recommend that patient comfort should be continually assessed during the procedure and sedation/analgesia titrated appropriately.（Evidence level: Low；Recommendation grade:Strong).