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Transcutaneous Pacemaker (External Pacemaker):
Used to treat unstable bradycardias not responding to drug therapy. Provides temporary pacing through the skin in emergency situations.
Place pads and electrodes in correct position to assure an appropriate ECG reading.
Set the pacer 10-20 beats per min above the patient’s intrinsic heart rate or 60 beats per min if there is no intrinsic heart rate.
Start at O mA and work energy level up until you have capture (heart pulsation).
Assure the patient is sedated and comfortable during pacer delivery.
Cardioversion:
Used if drug therapy and vagal maneuvers fail.
Used when patient has a pulse.
Used to treat Atrial Fibrillation, Atrial Flutter, Atrial Tach, and Symptomatic VT.
Shock performed at peak of R wave.
Requires proper lead/pad placement to monitor ECG.
Shock energy level:
Monophasic: 100-200J
Biphasic: factory recommendations (generally 100J)
Assure the patient is sedated and comfortable during shock delivery.
Defibrilation:
Used to treat VF and pulseless VT.
Delivery within first 5 mins of cardiac arrest has best results.
CPR before and after each shock improves outcomes.
Shock energy level:
Monophasic: 360J
Biphasic: factory recommendations (generally 120-200J)