9 determine optimum threshold, Pediatric pacing – ZOLL Propaq MD Rev A User Manual

Page 184

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E

XTERNAL

P

ACING

15-8

www.zoll.com

9650-0805-01 Rev. A

Mechanical capture is assessed by palpation of the peripheral pulse.

To avoid mistaking muscular response to pacing stimuli for arterial pulsations, use ONLY the
following locations for palpating pulse during pacing:

femoral artery

right brachial or radial artery

Effective pacing

Changing ECG leads and size can sometimes be helpful in determining capture.

Note:

The shape and size of the paced ECG waveforms can vary depending on the ECG lead
configuration chosen; variation from patient to patient can be expected.

9 Determine Optimum Threshold

The ideal pacer current is the lowest value that maintains capture — it is usually about 10%
above threshold. Typical threshold currents range from 40 to 80 mA. Location of the hands-free
or therapy electrodes affects the current required to obtain ventricular capture. Typically the
lowest threshold is obtained when the position of the electrodes provides the most direct current
pathway through the heart while avoiding large chest muscles. Lower stimulation currents
produce less skeletal muscle contraction and are better tolerated.

Pediatric Pacing

Noninvasive pacing of pediatric patients is performed in an identical manner to adult pacing.
Smaller size pediatric therapy electrodes are available for patients weighing less than 33 lbs/15
kg. If it is necessary to pace for more than 30 minutes, periodic inspection of the underlying
skin is strongly advised. Carefully follow all instructions on electrode packaging.

Pace Fault

The Propaq MD unit may display the following messages when pacing.

System Message

Description

PAUSED

The pacer has paused pacing the patient.

PACING

The pacer is pacing the patient.

PACING: CHECK THERAPY
ELECTRODES

Therapy pads are not connected or are not
making good contact with the patient. Apply
therapy pads to the patient.

ECG FAULT: PACING IN FIXED MODE

The pacer is pacing in Fixed mode because
the ECG lead displayed in the primary
waveform is faulted.

PACING: SHORT DETECTED

The pacer output is short circuited due a test
plug connection or a device/MFC fault.

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