TEMPORARY PACEMAKER THERAPY – Definition, Purpose, Equipment, Pre-temporary Pacemaker Care and After Care
DEFINITION
Temporary pacing is used in emergent or elective situations that require limited, short-time pacing.
PURPOSE
- Same as permanent pacemaker implantation, but when conduction defect is transform, like in:
Myocardial infarction complicated by heart block
Cardiac arrest with bradycardia and asystole
Selected postoperative cardiac surgery patients
EQUIPMENT
External pulse generator, bipolar electrode catheter set, sterile pack or IV cut down set, micropuncture set, cardiac monitor, scalpel blade, 100 ml normal saline, syringe 10cc, gloves 2 pairs, Betadine solution, local anesthetic agent, dislet wire and 6 f side arm.
PRE-TEMPORARY PACEMAKER CARE
- Explain procedure and purpose
- Get consent from patient/relative
- Gather equipment required
- Check functioning of external pulse generator
- Assess vital signs and obtain rhythm strip
- Monitor ECG and vital signs continuously
AFTER CARE
- Assess vital signs and emotional reactions to procedure
- Secure and check all connections
- Monitor battery and control setting
- Clean and dress incision site
- Keep pulse generator from electromagnetic interference
- Protect pulse generator from electromagnetic interference
- Check electrical equipment for adequate grounding
- Limit movement of extremity at insertion site
- Stabilize arm, catheter and pacemaker to an arm board and avoid movement of arm above shoulder level
- Do not lift patient from under arm
- If removal vein is used, limit movement of affected leg especially hip flexion and outward rotation
- Monitor pacemaker function
- Document location and type of pacing lead
- Instruct patient to report syncope, palpitation, light headedness or chest pain
