We all know by now that transcutaneous pacing (TCP) is no longer recommended for asystolic arrest.
But what about patients who experience return of spontaneous circulation?
Consider the following case.
EMS is called to an assisted living facility for a 79 year old female who is found collapsed outside her apartment door.
On arrival, the staff is providing adequate chest compressions.
The cardiac monitor is attached.
Chest compressions are continued, the airway is captured with a tracheal tube, an IV is initiated, and 1 mg of epinephrine is given IV.
The patient has a faint pulse but a blood pressure cannot be auscultated. The patient is prepared for transcutaneous pacing (TCP).
The pacer is set to 80 PPM and paramedics report capture at 110 mA.
With this rhythm on the monitor the patient’s BP is 118/68 and she radial pulses that correspond to the monitor.
Do you agree that capture has been achieved?
Is there anything else you would want to do at this point?
You are 10 minutes from your local receiving hospital.