Transcutaneous Pacing

Question 1

Transcutaneous pacing - indications (3 - all must be present)

Answer 1

1. Patient 16yrs or over
2. HR <40 AND haemodynamically unstable ie:
   - BP <90mmHg
   - Poor skin perfusion
   - Poor cerebral perfusion
3. Patient has failed to respond to pharmacology

Question 2

Transcutaneous pacing - contraindications (6)

Answer 2

1. Cardiac arrest in asystole/PEA
2. Overdrive pacing of a ventricular dysthythmia
3. < 16 years old
4. Haemodynamically stable
5. HR >/= 40
6. Unable to complete Conscious Sedation Checklist

Question 3

Transcutaneous pacing - complications (3)

Answer 3

• failure to increase electrical current high enough to obtain capture
• failure to confirm presence of mechanical capture (increasing LOC and radial/femoral pulse that matches paced rate)
• failure to monitor patient to ensure ongoing mechanical capture