ZOLL Propaq MD Rev A - Manual (Page 181)

Pacing in Fixed Mode
9650-0805-01 Rev. A Propaq MD Operator’s Guide 15–5
Warning! Determination of electrical capture should only be performed by viewing the ECG trace
on the Propaq MD display with its ECG connection directly attached to the patient. Use
of other ECG monitoring devices might provide misleading information due to the
presence of pacer artifacts.
Mechanical capture is assessed by palpation of the peripheral pulse.
To avoid mistaking muscular response to pacing stimuli for arterial pulsations, use ONLY the
following locations for palpating pulse during pacing:
• femoral artery
• right brachial or radial artery
Effective pacing
Changing ECG leads and size can sometimes be helpful in determining capture.
Note: The shape and size of the paced ECG waveforms can vary depending on the ECG lead
configuration chosen; variation from patient to patient can be expected.
9 Determine Optimum Threshold
The ideal pacer current is the lowest value that maintains capture — it is usually about 10%
above threshold. Typical threshold currents range from 40 to 80 mA. Location of the hands-free
or therapy electrodes affects the current required to obtain ventricular capture. Typically the
lowest threshold is obtained when the position of the electrodes provides the most direct current
pathway through the heart while avoiding large chest muscles. Lower stimulation currents
produce less skeletal muscle contraction and are better tolerated.
Pacing in Fixed Mode
If ECG electrodes are not available or there is some circumstance that prevents or interferes
with the surface ECG, the Propaq MD delivers pacemaker pulses at a fixed rate.
Fixed pacing should be performed only in an emergency when no alternative is available.
1 Turn Unit On
Press the green power switch located on the top of the unit. The green, yellow, and red lights at
the top of the unit flash on and off, and the unit displays the message SELF TEST PASSED.
2 Apply ECG Electrodes/Hands-Free Therapy Electrodes
Apply ECG electrodes, attach lead wires, and connect the ECG cable to the Propaq MD side
panel (see Chapter 6 for instructions on attaching ECG electrodes to the patient). Attach hands-
free therapy electrodes according to instructions on the electrode packaging. Connect these
therapy electrodes to the MFC.