Pacemaker Learning Package
Intensive Care: Learning Packages Intensive Care Unit Pacemaker Learning Package
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Intensive Care: Learning Packages Intensive Care Unit Pacemaker Learning Package LH_ICU2016_Learning_Package_Pacemaker_Learning_Package 39 | P a g e Removal of pacing wires Routinely removed on Day 3 –5 Patient must be in sinus rhythm Patients on Warfarin must have INR less than 2.5 Patient in bed before removal as tamponade is complication post removal They are removed by constant gentle traction, allowing the motion of the heart to assist dislodgement from the epicardium. Patient should be on bed rest for 2 hours post removal Equipment: gloves, stitch, cutter, gauze, opsite. Pull out wires you will feel heart pulsating & slight resistance Check end of wires are intact Liverpool Hospital Intensive Care: Learning Packages Intensive Care Unit Pacemaker Learning Package LH_ICU2016_Learning_Package_Pacemaker_Learning_Package 40 | P a g e Precautions Do not attempt to change battery while pacing a dependent patient. Asynchronous operation has the potential to induce life threatening arrhythmias. Ensure a defibrillator is at hand, and return to synchronous operation as soon as possible Ensure that implanted temporary pacing wires are properly insulated when not connected to the pacemaker, as these provide a direct electrical connection to the myocardium…. ONLY handle the pacing wires with GLOVES For EMERGENCIES always keep a spare pacing box on the emergency trolley (battery included) Requires 9v battery Prior to turning on check settings are appropriate Check pacemaker mode is on DDD on return from OT DDD is the safest mode to use for post op cardiac patients unless otherwise indicated |