Quote from DustinRN
I've never had a patient with TVP or TCP. Are there no spikes on the ECG to show you when the pacemaker is firing? I've never had a patient with one so I'm just wondering.
A 'TVP' will show spikes w/bundles the same way a permanent pacemaker does.
A 'TCP' will (usually) show spikes and big bundly-looking things... regardless of whether or not it is 'capturing' the pt's heart. Thats the trick with TCP's and why the EP-doc told the origional poster that you'd have to feel a pulse to confirm capture. So...if you're ever pacing someone (TCP), and you see the TCP spikes 'capturing' on tele, you had best make sure as you may only be 'capturing' someones chest wall. And another tricky thing is that sometimes the discharges can produce a 'psuedo-pulse' where someone feels muscle-contractions (synchronous w/pacer discharges) and assumes it's a pulse...
In the OP's scenario, i'd surely feel for a pulse, but would feel better going by the pt's level of conciousness...You know they're perfusing if they're still talking.
And as far as the OP's post is concerned, if that patient were being TCP'd at any point I'd be electing that doc for a swift arse-paddling (for not placing a temp./TVP as a bridge to PPM)
TCP is not something you can handle for too long without (or with!) sedation. If the TCP is just 'stand-by' that may be a different story...