Transcutaneous pacing

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Background

Indications

  1. Bradyarrhythmias causing hemodynamic impairment:
    1. AV block
    2. Sinus node dysfunction
    3. A-fib w/ slow ventricular response
    4. Malfunction of implanted pacemaker
  2. Tachyarrhythmias causing hemodynamic impairment

Procedure

  1. Pad placement:
    1. Pad on apex of heart and on R upper chest
    2. Pad on lead V3 position and btwn L scapula and T-spine
  2. Set: HR 80, pacing threshold usually btwn 40-80 mA
    1. Look for clear QRS complex and T-wave following pacer spike
    2. Check pulse to confirm mechanical capture
    3. Final current set 5-10 mA above threshold level for pt

See Also

ACLS: Bradycardia

Source

  • Roberts and Hedges, Clinical Procedures in Emergency Medicine