*Exactly* How Do You Actually Pace?

[GypsyMedic]

Dirt, you and I must go to the same hospitals! Had the same thing happen to me. Classic case, tried Atropine, didn't work, paced the patient and she was doing fantastic! Got her to the hospital and doctor waved his arms around & hollared we were shocking her too much and took the pads off. :shock: In the end, well...that was the end. Sometimes I hate going to "closest appropriate facility."

[EMT Foose]

So, awhile back, we had a bradycardic ALOC patient from nursing home 911 call. He went into and out of PEA. Atropine didn't work, so we were going to just transport like usual. Then, I was truly impressed...a FF actually wanted to try TCP. You don't understand how huge this is that someone would actually try this in these parts.... I

I give her points for that...but then both medics who rode in with us had no idea how to actually do it. Since I was closest to the monitor (Zoll), they had me moving both dials every which way. They had me turn each dial from really low to really high until they got scared and had me go back down...I felt like 3 new EMTs had been handed a monitor to play with.

So my question is: EXACTLY how do you do the physical process of pacing? Where do you start your dials, where do you move them to, what do you look for on the screen, how do you know you've captured, etc etc.

Yikes!

Were these medics from a dinosaur station I hope?

That's basic ACLS stuff.

[AnthonyM83]

Yikes!

Were these medics from a dinosaur station I hope?

That's basic ACLS stuff.

Naw...from one of the busier areas in the county, actually. They had plenty of times to practice this.

I guess they were so confused about what they did in the rig, they didn't even mention in the PCR that pacing was attempted or that he had intermittent pulses. Just brought it in as a full arrest.

[akroeze]

So did this patient end up in arrest?

[AnthonyM83]

Yup. He went in and out of it a couple times on-scene and as we brought him into the ER. They called him there after a few minutes.

[mobey]

In the end, well...that was the end. Sometimes I hate going to "closest appropriate facility."

Hmmm... If you are going to a hospital where you know there is a panicky air-head doctor on shift, I wonder if you still have to deem it the "Closest appropriate facility"

[Just Plain Ruff]

It sure sounds like these two medics should not consider pacing another patient until they get some remedial training.

[zzyzx]

Why the heck were they having you turn the dials? Did they also ask you to get the tube and the IV for them?! It is possible that they just couldn't get capture with this patient's dying heart, but yeah, pretty sad that they weren't totally familiar with their equipment.

I will say that the LA county FF in my medic class were all good guys. They seemed to really want to be good medics, and in fact our class valedictorian was a county FF.

[AnthonyM83]

Was he an older skinny guy? (let's not say names) If so, he's a very caring FF (maybe because of his age) and I always enjoy running calls with him.

[zzyzx]

Yeah, that might be him! I forget his name...maybe Tim. He's about 40 y/o but looks younger; looks like a surfer. Besides being the valedictorian, he was also the nicest guy in class.