Transcutaneous pacing: Difference between revisions

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==Indications==
==Indications==
#Bradyarrhythmias causing hemodynamic impairment:
*[[Bradyarrythmia]]s causing hemodynamic impairment:<ref name="AHA">Epstein AE, DiMarco JP, Ellenbogen KA, et al. ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. Circulation. May 27 2008;117(21):e350-408</ref>
##AV block
**[[AV block]]
##Sinus node dysfunction
**Sinus node dysfunction
##A-fib w/ slow ventricular response
**[[A-fib]] with slow ventricular response
##Malfunction of implanted pacemaker
**Malfunction of implanted pacemaker
#Tachyarrhythmias causing hemodynamic impairment
*[[Tachyarrhythmias]] causing hemodynamic impairment<ref name="AHA"></ref>


==Procedure==
==Procedure==
#Pad placement:
[[File:True-capture.png|thumb|True electrical capture]]
##Pad on apex of heart and on R upper chest
[[File:False-capture.png|thumb|False capture with visible phantom beats<ref>"Transcutaneous Pacing (TCP): The Problem of False Capture". EMS 12 Lead. Retrieved 2019-01-31.</ref>]]
##Pad on lead V3 position and btwn L scapula and T-spine
*Pad placement:
#Set: HR 80, pacing threshold usually btwn 40-80 mA
**Pad on apex of heart and on right upper chest
##Look for clear QRS complex and T-wave following pacer spike
**Pad on lead V3 position and between left scapula and T-spine
##Check pulse to confirm mechanical capture
*Set: HR 80, pacing threshold usually between 40-80 mA
##Final current set 5-10 mA above threshold level for pt
**Look for clear QRS complex and T-wave following pacer spike
**Check pulse to confirm mechanical capture
**Final current set 5-10 mA above threshold level for patient


==See Also==
==See Also==
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*[[Transvenous pacing]]
*[[Transvenous pacing]]


==Source==
==References==
*Roberts and Hedges, Clinical Procedures in Emergency Medicine
<references/>


[[Category:Procedures]]
[[Category:Procedures]]
[[Category:Cardiology]]
[[Category:Critical Care]]

Revision as of 15:54, 10 October 2019

Background

Indications

Procedure

True electrical capture
False capture with visible phantom beats[2]
  • Pad placement:
    • Pad on apex of heart and on right upper chest
    • Pad on lead V3 position and between left scapula and T-spine
  • Set: HR 80, pacing threshold usually between 40-80 mA
    • Look for clear QRS complex and T-wave following pacer spike
    • Check pulse to confirm mechanical capture
    • Final current set 5-10 mA above threshold level for patient

See Also

References

  1. 1.0 1.1 Epstein AE, DiMarco JP, Ellenbogen KA, et al. ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. Circulation. May 27 2008;117(21):e350-408
  2. "Transcutaneous Pacing (TCP): The Problem of False Capture". EMS 12 Lead. Retrieved 2019-01-31.