ZOLL R Series Monitor Defibrillator Rev J - Manual (Page 270)

C HAPTER 9 N ONINVASIVE T EMPORARY P ACING (O PTIONAL )
9–8 www.zoll.com 9650-0904-01 Rev. K
Special Pacing Applications
Noninvasive Temporary Pacing can be performed in the Cardiac Catheterization Lab either for
emergency pacing or standby pacing. For pacing in X-ray and fluoroscopic applications, ZOLL
pro-padz
®
radiolucent hands-free therapy electrodes may be used.
Noninvasive Temporary Pacing can be performed in the Operating Room using ZOLL
pro-padz sterile hands-free therapy electrodes.
Caution Under certain conditions, it might not be possible to properly monitor or pace while
electrosurgical apparatus is operating. Observe the device carefully for evidence of proper
operation.
Standby Pacing
For certain patients at risk of developing symptomatic bradycardia, it may be advisable to use
the unit in standby mode. When used in standby mode, the unit automatically provides pacing
stimuli whenever the patient’s heart rate drops below the pacer rate setting. Patient’s ECG must
be monitored using one of the two electrode configurations described on page 8-2. To use the
device in standby mode:
1. Establish effective pacing (see instructions on previous pages). Note the mA output at
capture and run an ECG stripchart to document ECG morphology during capture.
2. Set the mA output 10% higher than the minimum mA output necessary to effect consistent
ventricular capture.
3. Turn the pacing rate (ppm) below the patient’s heart rate. This suppresses pacing unless the
patient’s own rate drops below the pacer rate setting. The pacing rate should be set at a level
sufficient to ensure adequate cardiac output.
4. Check the threshold periodically.
Asynchronous Pacing
If ECG electrodes are not available or there is some circumstance that prevents or interferes
with the surface ECG, the R Series delivers pacemaker pulses asynchronously.
Asynchronous pacing should be performed only in an emergency when no alternative is
available. To pace asynchronously: