Transcutaneous pacing: Difference between revisions

 
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==Indications==
==Indications==
*Bradyarrhythmias 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>
*[[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]] with slow ventricular response
**[[A-fib]] with slow ventricular response
**Malfunction of implanted pacemaker
**Malfunction of implanted pacemaker
*Tachyarrhythmias causing hemodynamic impairment<ref name="AHA"></ref>
*[[Tachyarrhythmias]] causing hemodynamic impairment<ref name="AHA"></ref>
 
==Contraindications==
 


==Procedure==
==Procedure==
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**Pad on lead V3 position and between left scapula and T-spine
**Pad on lead V3 position and between left scapula and T-spine
*Set: HR 80, pacing threshold usually between 40-80 mA
*Set: HR 80, pacing threshold usually between 40-80 mA
**If hemodynamically unstable or with evidence of end organ poor perfusion start at 80 mA and titrate down as tolerated.
**Look for clear QRS complex and T-wave following pacer spike
**Look for clear QRS complex and T-wave following pacer spike
**Check pulse to confirm mechanical capture
**Check pulse to confirm mechanical capture
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*[[ACLS: Bradycardia]]
*[[ACLS: Bradycardia]]
*[[Transvenous pacing]]
*[[Transvenous pacing]]
==External Links==
*[https://www.acepnow.com/article/transcutaneous-transvenous-cardiac-pacing/ ACEP - Transcutaneous and Transvenous Cardiac Pacing]
*[https://www.downeastem.org/common-bedside-procedures-1 Downeast EM - Transcutaneous Pacing]
===Videos===
{{#widget:YouTube|id=ZMGHyjIAjUs}}


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

Latest revision as of 18:43, 16 July 2021

Background

Indications

Contraindications

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
    • If hemodynamically unstable or with evidence of end organ poor perfusion start at 80 mA and titrate down as tolerated.
    • 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

External Links

Videos

{{#widget:YouTube|id=ZMGHyjIAjUs}}

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.