7307 Transcutaneous Cardiac Pacing

Question 1

Indications

Answer 1

S/S of poor systemic perfusion AND

Significant bradycardia(<60) present on ECG AND

Underlying causes of the dysrhythmia have been considered and reversible causes have been treated AND

Confirm no contraindications AND

Place equipment properly and get baseline treatment (12 lead preferred if able to obtain without causing harm)

Question 2

Contraindications

Answer 2

Children less than or equal to 12 years old (respiratory causes should be assumed)

Asystolic arrest, unless approved by the hospital

Question 3

Preparation

Answer 3

Administer 2 doses of atropine while setting up pacer (do not delay TCP if IV access is difficult)

Use right away for high degree block (2nd type 2 and 3rd)

Strongly consider Versed and Morphine while setting up. Use IN/IM routes if necessary