Need help with Temporary Pacers!!

I have trouble understanding the sensing portion of temporary pacers. It has always seemed backwards to me. I need help explaining this to some new nurses and am not sure enough about it to speak with authority. Let me see if I'm getting this right......If your pacer is undersensing (not picking up the intrinsic beat) you need to increase your sensitivity by turning the sensitivity down. And, on the flip side, if your pacer is over sensing (picking up external things it shouldn't) you should decrease your sensitivity by turning the sensitivity up...Am I saying this right? Is there an easier way to teach this?

You're correct in how you just explained it. It's a bit strange, yes?

A simpler way of teaching it would be this...

Think of the 'sensing' part of your pacemaker as an eye...and the patient's rhythm as what it is 'looking at'.

Now...think of your 'sensitivity setting' as a wall between the eye and what it's sensing/seeing.

If you're over-sensing(seeing too much), the wall is too low and needs to be 'turned up' (making the wall taller) and your eye will then be less able to see/sense all the extra stuff. (thus..turn it 'up' to make you see 'less')...

And...if your undersensing (not seeing enough), the wall needs to be lowerd/turned down, so that your eye can see more...(wall/sensitivity being turned 'down'...so you can see 'more')...

Thats a little rough....but do you get the drift???

It works so MUCH BETTER with pictures...(or little sketches on the back of your kardex...etc. :) )

I leared the brick wall approach.....when you are sensing and it's correct, you have a medium sized brick wall which is perfect you can see over the wall just enough but not too much.

When the wall is too high - it can't sense because you can't see - therefore you need to take down some bricks (turn it down) to get the correct amount of bricks.

When the wall is too low - you see (sense) like crazy - therefore you need to add more bricks to the wall and make it not see as well (turn it up).

The sensitivity terminology, IMHO, is not that great--it does seem backwards. I think a better term would be "sensing threshold" rather than "sensitivity".

We really need to come up with a good way to teach sensitivity, it messes with peoples minds, even people who know what they mean to say cant explain it well. The brick wall is a good metaphor. I was trying to think of others, but have hit, pardon me, a brick wall..........

Grace:uhoh3: