ZOLL Propaq MD Rev A - Manual (Page 183)

Pacing in Fixed Mode
9650-0805-01 Rev. A Propaq MD Operator’s Guide 15–7
5 Set Pacer Rate
Use the arrow keys to navigate to Rate, press the Select button, then use the arrow keys and the
Select button to set the Pacer Rate to a value 10-20 ppm higher than the patient’s intrinsic heart
rate. If no intrinsic rate exists, use 100 ppm. You can increase or decrease the pacer rate by a
value of 5 ppm for rates below 100, and by 10 ppm for rates above 100.
Note: The initial pacing rate can be set in Defib/Pacer Default settings in the Supervisor
Setup menu.
6 Turn Pacer On
Use the arrow keys to navigate to Start Pacer, and press the Select button to select it. The
Pacing window displays behind the Pacer Settings window.
Note: You will be prompted to disable the pacer if the defibrillation window displays while
the pacer is on.
7 Set Pacer Output
In the Pacer Settings window, use the arrow keys and the Select button to adjust the pacer
output. The pacer output is adjustable in 10 mA increments when increasing the output, and in
5 mA increments when decreasing the output. Observe the ECG for evidence of electrical
capture. Select the lowest output current that achieves both electrical and mechanical capture.
Note: If the Pacer Settings window disappears before you have set the output current, press
the Pacer button again to display the settings window.
8 Determine Capture
It is important to recognize when pacing stimulation has produced a ventricular response
(capture). Determination of capture must be assessed both electrically and mechanically in
order to ensure appropriate circulatory support of the patient.
Electrical capture is determined by the presence of a widened QRS complex, the loss of any
underlying intrinsic rhythm, and the appearance of an extended, and sometimes enlarged, T-
wave.
Ventricular response is normally characterized by suppression of the intrinsic QRS complex.
Warning! Determination of electrical capture should only be performed by viewing the ECG trace
on the Propaq MD display with its ECG connection directly attached to the patient. Use
of other ECG monitoring devices might provide misleading information due to the
presence of pacer artifacts.
PACING
60
ppm
Rate
70
mA
Output
Demand
Mode