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What is a definitive treatment to offer a
patient in third degree heart block with a
QRS width of 0.12 seconds?
1. Atropine 0.5mg IV
2. Transcutaneous pacemaker
3. Epinephrine 1mg IV
4. Dobutamine 2-10mcg/kg per min
• Transcutaneous pacing (TCP) electrical stimulation from
electrode pads to induce cardiac depolarization
• Short periods
• Therapeutic bridge
• Electrical concepts
– Electrical circuit
• Pacemaker to patient, patient to pacemaker
• Severe hypothermia
• Resuscitation supplies
– Rate
• Set the rate 20 above patient intrinsic rate
• If no intrinsic rate, set to 100
– Energy
• Pacemaker initial output of 0 mA
• Increase the output until each pacer spike is
followed by a wide QRS complex (electrical
capture)
• Decrease the output mA to maintain capture at the
lowest possible energy
• In cardiac arrest start at max energy and decrease
the output after capture is achieved
• Refers to the successful stimulation of the myocardium
that results in depolarization