FOAM does a great job of providing resources for helping to learn and teach challenging procedures such as transvenous pacing. No matter how beautiful a book illustration may be, some procedures simply must be demonstrated to be understood. So in addition to Dr. Bellezzo’s lecture and Dr. Sacchetti’s video, we also refer people to a video by Jason Nomura, MD (@Takeokun), “Practical Pointers on Setting Up Emergent Pacing.” Dr. Nomura’s video is particularly useful because it shows looping short clips of various aspects of the procedure so you can see what to do repeatedly without having to rewind over and over again. For a wonderful combination of videos, diagrams, and text, also check out “Dr. Smith’s ECG blog” by Stephen Smith, MD (@smithECGblog), at hqmeded-ecg.

Whether your patient has unstable bradycardia or another emergent need for pacing, we are curious what your approach is. Any tricks for successful placement of either transcutaneous or transvenous pacers? We’d love to hear them. Tweet at us @FOAMpodcast or visit our website. See y’all online!

Dr. Faust is a clinical instructor at Harvard Medical School and an attending physician in department of emergency medicine at Brigham & Women’s Hospital, Boston, Massachusetts.

Dr. Westafer is an attending physician and research fellow at Baystate Medical Center, clinical instructor at the University of Massachusetts Medical School in Worcester, and co-host of FOAMcast.

References

1. Lang R, David D, Klein HO, et al. The use of the balloon-tipped floating catheter in temporary transvenous cardiac pacing. Pacing Clin Electrophysiol. 1981;4(5):491-496.
2. Rosenberg AS, Grossman JI, Escher DJ, et al. Bedside transvenous cardiac pacing. Am Heart J. 1969;77(5):697-703.