Transcutaneous Pacing Success!!! Part 1

Anyone trained in transcutaneous pacing (TCP) needs to be able to identify the rhythm below instantly. Successful transcutaneous pacing? It shows a patient being transcutaneously paced at 80 bpm and 125 mA on a LifePak 12 [the strip is labelled 130 mA but that refers to a point just past the end of the paper, I promise]. Well, actually, it shows attempted pacing. Despite the generous current being delivered there is no evidence of successful electrical capture. Without electrical capture there cannot be mechanical capture, so the patient’s pulse at the moment is actually 10 bpm. Here are the patient’s two native QRS complexes—the only ones generating a cardiac output as a result of his exceedingly slow baseline rhythm. Though they resemble QRS complexes, the fourteen other “blips” you see on the strip are actually just artifact from the pacer. This phenomenon is commonly referred to as “false capture” and it is a huge problem.   The Problem of False Capture On November 12, 2008, Tom Bouthillet published an article on this blog that hit me as a revelation and changed the way I approach transcutaneous pacing. Transcutaneous Pacing (TCP) – The Problem of False Capture You need to go read his article right now. I’ll wait here. Before encountering that post I had no idea how difficult it could be to achieve and identify successful transcutaneous pacing. Since then I’ve seen dozens of cases of attempted TCP—both in person...
Source: EMS 12-Lead - Category: Cardiology Authors: Tags: Cases Transcutaneous Pacing Vince DiGiulio Source Type: research