Transvenous Pacers

  1. Am encountering transvenous pacers in my unit. Would appreciate any advice/information from you more experienced nurses out there. Am reading up on these, not a whole lot of info available--any good websites?
    PS. I know this sounds like a dumb question, but what is the little balloon for and where does it inflate?

    THANKS!!!
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  2. 4 Comments

  3. by   moonshadeau
    If you are talking about the temporary pacers that are placed in cases of emergency, best advice I can tell you is to make sure that the wires are always secured. It seems that the heart is fairly particular when it is dependent on the pacer and suddenly the wires fall out. Not a good thing.

    This is a good website for pacer infohttp://nursing.about.com/gi/dynamic/offsite.htm?site=http%3A%2F%2Fwww.geocities.com%2F markhammerschmidt%2F

    As for the balloon, it was always my understanding that the intent was so that the guide wire inside the vasculature wouldn't fall out of place. But if I am wrong someone can sure correct me.
  4. by   moonshadeau
  5. by   RNcDreams
    Hi!
    I can give you the "novice" experience with Transvenous pacers...

    One of the first critical patients my preceptor and I worked with (in the ED) was a man who came in with c/o fatigue... and lo and behold, he was in a 3rd degree block.

    Since it was persistent and unresponsive to meds/tc pacing, the tv pacer was needed until he could get to the OR for placement of a permanent one.

    The balloon, to the best of my knowledge, is to keep the pacer in the appropriate area.

    Double check the website for the specific vessels involved!
  6. by   alinse00
    I've been told that only time and experience make you comfortable with transvenous pacing...after being a nurse for only a year and a half I certainly am not there yet!

    My first experience with this was the scariest. Pt's admitting diagnosis was syncope and she mentioned to me that she while checking her BP at walmart every week she had a heartrate in the 30's. She didn't know this was abnormal so she didn't see a physician! Well not more than 30 minutes later the monitor alarms off, shes in complete heart block with a rate of 30. I run to the room, she is up in the bathroom (which of course she was NOT supposed to do without calling me) c/o feeling lightheaded. BP remained stable and the cardiologist was on his way. Told us not to transcutaneous pace as long as the condition did not further deteoriate. He can in and put in transvenous pacing wires through her right jugular. All went well....until he left....
    She was asymptomatic but the pacer wasn't capturing right. Since this was my first experience I called him and he said check the wires. They were secure, still not caputuring. Turned up the MA's with the help of the charge nurse, still not capturing all the time. Dr said he would be in shortly. I left for the day and the next night when i came back I was told the dr was angry for coming in to find loose wires...

    My second experience was similiar and im so confused!! The wires were secure and tight to the pacer...is there something i'm not thinking about here??

    All I know is it STILL makes me nervous when they go in through the jugular!

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