VS: 97.4 38-26. 204/89. Monitor, oxygen, IV started. 0.5 mg of atropine given. No change in rhythm.
Initiate transcutaneous pacing. Rate 60 ppm
Increased milliamps to 50. No mechanical capture
Increased milliamps to 60. No mechanical capture
Demand pacing. Underlying rhythm 1st degree block with periods of arrest.
She had good capture at 70 mAs. She had a lot of musculoskeletal contractions. It was difficult to even feel a femoral pulse. A doppler was used and it found her heart rate to be in the 40s. At this point, we increased the mAs up to 90. The doppler rate was now 60 ppm
90 mAs. Doppler rate 60 ppm. SpO2 rate correlates too.
100% paced with good mechanical capture by doppler. Patient sent to cath lab for transvenous pacemaker insertion.