Transcutaneous Pacing Success!!! Part 2

This is the second half of a two-part case presentation examining transcutaneous pacing. If you didn’t see yesterday’s post I highly suggest checking out Part 1 before continuing, but if you hate learning I suppose you can start here. Yesterday we examined a series of tracings that depicted transcutaneous pacing (TCP) in all its stages: initiation, false-capture, intermittent capture, successful capture, and finally, spontaneous resolution of the bradycardia that necessitated pacing in the first place. It was a whirlwind! Intermittent capture with the Lifepak 12 set at 150 mA and 80 bpm. As we mentioned in that post, however, there was a catch: We only discussed success in terms of electrical capture. What about mechanical capture? What good is it to achieve good electrical capture if we can’t confirm that the patient’s cardiac output has actually increased? That is today’s topic.   Pad Placement Before we actually get into the topic at hand I need to touch on something that has come up several times recently. Maybe it’s just a coincidence, but of late I’ve seen several crews that I work alongside bring in patients with anterior-posterior pad placement—my preferred setup for either pacing or defibrillation—however some wires must have gotten crossed in training because the pads are set up like the patient is 7 years old. Image source. As the image above demonstrates, sternal-spinal pad placement is only recommended for pediat...
Source: EMS 12-Lead - Category: Cardiology Authors: Tags: Cases Transcutaneous Pacing Vince DiGiulio Source Type: research