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F.Y.MSc Nursing
Dr.D.Y.Patil CON
Definition
Pacemakers are an electronic device used to
pace the heart when the normal conduction
pathway is damaged or diseased
COMPONENTS OF PACEMAKER
• Pulse generator
• Pacemaker electrodes
WORKING OF PACEMAKER
TYPES OF PACEMAKER
a) Temporary pacemaker
b) Permanent pacemaker
TEMPORARY PACEMAKER
PROCEDURE
TRANSCUTANEOUS PACEMAKER (NON-
INVASIVE PACING)
EQUIPMENTS
• Disposable pacing
• ECG
• Jelly
• Electrode pads
• Resuscitative equipment
• External pacing module s
Nursing Action Rational
Preparatory phase
1. Explain procedure to patient. 1. Allays anxiety.
2.Explain sensation of discomfort with
2.Discomfort is felt with each firing but can
external pacing
be relieved with analgesic
Performance phase
instructions and patient condition. If patient’s pace only if heart rate falls below the set rate
heart rate is consistently too low to maintain
adequate cardiac output, set rate at 70–80. If
the patient’s rate falls only intermittently and
the pacemaker will be used in the demand
mode, set rate at 60
5. Gradually increase mA output until a pacing 5. If using the demand mode, set the rate
spike and a corresponding QRS complex is higher than the patient’s rate to establish the
seen (perhaps as high as 70 mA or more correct output and capture, then return the
6. Palpate pulse on right side to ensure rate to 60. 6. Choose either right radial or
adequate response to electrical event brachial pulse since muscular contractions
that may be transferred down the left arm
can cause misinterpretation
7. Patient perspiration may cause pads to
7. Check pad placement frequently loosen or slip
Follow-up phase
1. Check vital signs at least every 15 minutes 1. Determines if cardiac output is adequate.
while continuous pacing is employed. Check Muscle contraction from pacing may interfere
blood pressure in right arm with blood pressure reading on left
2. Monitor ECG continuously for pacer 2. Detects malfunction (may occur due to
functioning. electrode loosening).
3. Assure patient that treatment is temporary 3. Should only be used continuously for 2
and prepare patient for transvenous or hours because sensation may be
since Micra TPS comes with two tiny prongs that directly touch the
heart, there’s no need for leads – wires that wind their way to the
heart to keep it beating. “Because of its small size and unique design,
the Micra TPS can be introduced directly into the heart via a
minimally invasive procedure, without the need for leads,
Medtronic, this device is the smallest in the whole world.
At just 24 millimeters and less than 1 centimeter in
volume, it’s one-tenth the size of average pacemakers.
New Piezoelectric Nanoribbon Implant Powers
Pacemakers
Tachyarrhythmia
Psychological
Physical
Obtain written consent from the patient and from nearest relative
Prepare the emergency cart, the defibrillator and jelly, and the ECG monitor
The nurse should know about the pacemaker generator including the power
switch, indicator light for pacing and sensing, stimulus output dial, sensitivity dial,
and their proper settings.
Assist the doctor and the scrub nurse during the procedure step by step
Observe vital signs and observe ECG monitor carefully for arrhythmias and other
complications.
Post-operative care
Receive the patient
Immobilize the affected part and keep in supine position but allow the
movement of finger and ankle joint.
Prevent infection.
Avoid lifting operative side arm above shoulder level until approved by care
provider.