What is nursing care of patient with transcutaneous pacing?

Transcutaneous Pacing – is a non-invasive method of stimulating myocardial depolarization through the chest wall via two large pacing pads. The multifunctional pads are placed on the anterior and/or posterior chest wall or just below Rt. Clavicle and Lt. Midaxillary line, below the nipple and are attached by a cable to an external pulse generator that houses the pacemaker control.

Transcutaneous pacing is initiated as a temporary short-term measure when there has been a failure of the normal conduction of the heart to produce an electrical impulse resulting in a hemodynamic compromise in the patient.

1. CCU/ICU Nurse shall adhere to standards of nursing care, documentation and safety relating to the use of external transcutaneous (external) pacing.
2. A detailed operation, troubleshooting and safety checks will be carried out as per the manufacturer’s operating manuals.
3. The initiation and indications for this treatment will be in accordance with the recommendations and guidelines described in the current ACLS algorithms.

CCU/ICU Registered Nurse should follow procedure guidelines in the AACN Procedure Manual for Critical Care, Procedure 48, Temporary Transcutaneous (external) Pacing, p. 333-339.

CCU/ICU Registered Nurse should maintain current certification in advanced life support or demonstrate competent clinical and technical skill in initiating transcutaneous pacing.

The physician should explain the procedure to the patient and/or the patient’s family and evaluate the patient to identify the need and writes the order.