tag:blogger.com,1999:blog-549949223388475481.post6265837604916342039..comments2024-03-28T14:02:08.119-05:00Comments on Dr. Smith's ECG Blog: Emergency Transvenous Cardiac PacingUnknownnoreply@blogger.comBlogger7125tag:blogger.com,1999:blog-549949223388475481.post-18446979373966271342015-07-30T10:26:30.820-05:002015-07-30T10:26:30.820-05:00Thanks, Ken!Thanks, Ken!Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-21565277736657684222015-07-30T02:44:57.140-05:002015-07-30T02:44:57.140-05:00GREAT case Steve! — with Thanks to Drs. Krob &...GREAT case Steve! — with Thanks to Drs. Krob & Sandefur for their assistance. Your outstanding step-by-step description with serial Echos that accurately illustrate events as they happen makes this a Textbook case worthy of bookmarking for frequent referral.ECG Interpretationhttps://www.blogger.com/profile/02309020028961384995noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-14810174147998262162015-07-29T08:35:02.044-05:002015-07-29T08:35:02.044-05:00Great overview of what would need to be done for t...Great overview of what would need to be done for this patient. That's an interesting looking ultrasound - not unexpected, but interesting. Thanks for sharing this!Jordanhttp://paulrajsamuelmd.com/noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-15054215055379025812015-07-29T06:55:24.128-05:002015-07-29T06:55:24.128-05:00George,
I don't know how often capture is achi...George,<br />I don't know how often capture is achieved, so I asked Tom Bouthillet, who knows more about it than I do. Below is what he wrote.<br />Steve<br /><br />Steve:<br /><br />There is very little in the peer reviewed literature. Mostly it speaks to TCP being ineffective for asystole. However, since no one seems to know how to perform the procedure in the first place, I have my doubts about that. I do recall one case where bedside ultrasound was used to confirm capture. I contacted the author and asked if he had the rhythm strips and he said that he didn't. How you can publish a study about TCP and not include the ECGs is baffling. I have been interested in this topic for 15 years and I have collected many dozens of cases. I can count the cases where true electrical capture was achieved on one hand. That's why I wrote Transcutaneous Pacing (TCP) - The Problem of False Capture to bring attention to it. I think it's one of the most underappreciated problems in ACLS. Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-91231262302813461062015-07-24T18:09:45.261-05:002015-07-24T18:09:45.261-05:00Hi there, many thanks for the cases, and your site...Hi there, many thanks for the cases, and your site in general! Had a very similar case to this this week- collapse, CHB, max atropine, bit of adrenaline- and like yours, transcutaneous pacing failed to capture adequately. Electrolytes all fine, pad placement changed, not acidotic- the cardio consultant that came in to put a pacing wire in said TC pacing often fails. In your experience, is there any reason for this, or is it just 'one of those things'? It was fairly alarming that what I'd previously considered a bit of a 'get out of jail free card' didn't actually get us/him out of trouble!George Readnoreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-24404488574596570222015-07-23T08:07:37.745-05:002015-07-23T08:07:37.745-05:00Those are indeed high doses. I would have given l...Those are indeed high doses. I would have given lower doses more frequently as needed. But it worked well.Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-58722176103437659412015-07-22T01:42:21.486-05:002015-07-22T01:42:21.486-05:00Hey Steve what a great write up and review. One qu...Hey Steve what a great write up and review. One questions though: 1. You stated you were giving push dose epi at .25mg per dose, but I always associated push dose epi using 5-20mcg per dose. Any thoughts on why the much higher doses?<br /><br />Thanks,onearmwonderhttps://www.blogger.com/profile/05544700853612013444noreply@blogger.com