SCCM Resource Library-Transvenous Pacemaker Procedural Help Sheet

Pdf Summary

This document is a help sheet created by Dr. Raymond Pashun from NYU Langone Medical Center and Grossman School of Medicine. It provides information on the placement of a transvenous pacemaker in an emergent setting. The resource is not endorsed by the Society of Critical Care Medicine.<br /><br />The help sheet includes tips for the procedure, such as preferred access sites (right internal jugular or left subclavian) and the use of a 6 Fr introducer. It also advises clinicians to confirm balloon inflation and connect the electrodes to the pacing generator. Initial generator settings include VVI mode, an output of 10 mA, and a rate of 60-80 bpm. The document suggests using echocardiography to assist with placement.<br /><br />Complications that may arise from the procedure are listed, including bleeding, pneumothorax, infection, dysrhythmias, and RV/septal perforation. Post-procedural considerations involve obtaining a chest X-ray and ECG, as well as testing the threshold daily.<br /><br />The help sheet also addresses troubleshooting for common issues with transvenous pacemaker placement. It highlights potential problems such as loss of capture, ventricular oversensing, and ventricular undersensing. ECG guidance is mentioned as a tool to assist with troubleshooting.<br /><br />In summary, this resource provides a brief overview of key technical aspects of transvenous pacemaker placement in an emergent setting. It includes procedural tips, information on complications, and guidance for troubleshooting common issues.

Asset Subtitle

Cardiovascular, Procedures, 2024, 0:10:00

Keywords

transvenous pacemaker

emergent setting

placement

access sites

6 Fr introducer

complications

echocardiography

post-procedural considerations

troubleshooting

technical aspects

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