When is transcutaneous pacing indicated

TCP causes a noninvasive electrical depolarization, thereby forcing contraction of the heart muscle. TCP maintains cardiac output by bypassing the underlying dysrhythmia. Temporary pacing is considered when a permanent pacemaker is not emergently indicated, not available, or the patient is too unstable for the procedure.

Prior to beginning pacing, consider reversible causes of the presenting dysrhythmia. Most often pacing is utilized in bradycardias, some reversible causes are myocardial infarction, electrolyte imbalances, drug toxicity, etc. Get familiar with the settings and how to manipulate the monitor to do what you need.

Assure the patient is kept as comfortable as possible prior to and during pacing. If unable to achieve capture before mA, reposition electrodes and begin again. Capture is the goal in TCP. When achieved, pacing is successful!

Mechanical capture is determined by a palpable pulse and other signs of increased circulation increased blood pressure, improvements in skin color and warmth, and improved level of consciousness.

Be sure to check for mechanical capture as well as electrical capture. Following capture, be sure to continue to reassess skin for burns and ensure adequate pain management.

This site uses Akismet to reduce spam. Overdrive pacing is used to stop symptomatic tachydysrhythmias. Indications : Hemodynamically significant hypotension, chest pain, pulmonary edema, altered mental status bradydysrhythmias unresponsive to atropine, asystolic cardiac arrest more likely to be successful when initiated early after a witnessed arrest—unwitnessed arrest seldom responds to transcutaneous pacing , failed intrinsic pacemaker. When considering institution of transcutaneous pacing, always think about alternate causes for acute dysrhythmia, e.

Treat underlying cause. Optimal placement for pads varies by manufacturer, but is generally anterior-posterior or anterior-lateral, with the former being most common.

Begin at 10 milliamps and increase by increments of 10 until capture is noted. Target rate is generally bpm. Strongly consider sedation, as external pacing can be quite uncomfortable. Article Tools Print this article. Indexing metadata. How to cite item. Finding References. Email this article Login required. Abstract Doukky Rand colleagues acknowledged that Transcutaneous Cardiac Pacing is a temporary method of pacing which may be indicated in patients with symptoms of severe or hemodynamically unstable bradyarrhythmias.

Keywords Atropine resistant bradycardia, Bradyarrythmias, Complications, Contraindications, Pacing indications, Transcutaneous pacing. Full Text: PDF. Sovari AA.