• Tom Bouthillet

Using Capnography to Confirm Capture with Transcutaneous Pacing (TCP)

Updated: Aug 14



Those of you who have been following me for a while (here and other online forums) know that I have been searching for cases where a patient was successfully paced with a Lifepak 12.


I have reviewed dozens of cases where the treating paramedic thought the patient was being paced, but the rhythm strips showed only false capture.


Imagine my surprise when Robbie Murray (Operations Chief for Sussex County EMS) taught a capnography class for Hilton Head Island Fire & Rescue!


It was a wonderful class, and I learned a lot about capnography, but the part that really stood out was a couple of rhythm strips that showed TCP with true electrical capture!


That’s just something you don’t see every day. Trust me on this point. I’ve been paying attention!


Robbie was gracious enough to email them to me so I could share them with you.


Apparently, for this intubated patient, there was a marked rise in CO2 as soon as electrical (and mechanical) capture was achieved. What a novel and interesting use of waveform capnography!


One thing I’d like to point out is that both of these rhythm strips show TCP @ 140 mA! That’s important because the most common mistake I’ve seen with TCP is failure to increase the milliamperes high enough to achieve electrical capture.


Yours truly captured @ 120 mA with the Lifepak 12.


So, chalk up another score for waveform capnography, and thanks again to Robbie Murray for sharing these interesting rhythm strips!



See also:

Transcutaneous Pacing (TCP): The Problem of False Capture

Revisiting Transcutaneous Cardiac Pacing

Transcutaneous Pacing Success!!! Part 1

Transcutaneous Pacing Success!!! Part 2

Transcutaneous Pacing: “Turn it up to eleven!”

Transcutaneous pacing (TCP) for asystole

Transcutaneous pacing (TCP) with a Lifepak 12

Using Capnography to Confirm Capture with Transcutaneous Pacing (TCP)

58 year old male CC: Unconscious (Transcutaneous pacing failure in the setting of hyperkalemia)


About Me

I am the Battalion Chief of EMS for Hilton Head Island Fire Rescue and obsessed with all things process improvement, system performance, human factors, crew resource management, and evidence-based performance measures for time-sensitive diagnoses.

Posts Archive