Transcutaneous pacing: Difference between revisions
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==Indications== | ==Indications== | ||
* | *[[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
- Bradyarrythmias causing hemodynamic impairment:[1]
- Tachyarrhythmias causing hemodynamic impairment[1]
Contraindications
Procedure
- 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
- ↑ 1.0 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
- ↑ "Transcutaneous Pacing (TCP): The Problem of False Capture". EMS 12 Lead. Retrieved 2019-01-31.