Pacemaker question

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Hi all,

I had a patient in the community who just went for pacemaker removal. I was about to do a dressing change but noticed that the site was open like a pocket, and had a packing. Is that normal? I wasn’t sure so I contacted my manager to send a wound care specialist.

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.

Interesting...this is one of those scenarios that require a lot of more digging into the case.  There are reasons for pacemaker generator removal (the actual box that's implanted subcutaneously) but in this patient's case, it may appear that the reason was infection given the site was left open with packing. The other question is whether the underlying reason or diagnosis for permanent pacemaker implantation is still active or resolved...if still active, I've seen a temporary externalized pacemaker generator (secured outside of the chest on the opposite side) while the infection is being treated.

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13 minutes ago, juan de la cruz said:

Interesting...this is one of those scenarios that require a lot of more digging into the case.  There are reasons for pacemaker generator removal (the actual box that's implanted subcutaneously) but in this patient's case, it may appear that the reason was infection given the site was left open with packing. The other question is whether the underlying reason or diagnosis for permanent pacemaker implantation is still active or resolved...if still active, I've seen a temporary externalized pacemaker generator (secured outside of the chest on the opposite side) while the infection is being treated.

You’re right, it was infected. They implanted a new pacemaker on the opposite side. 

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Specializes in retired LTC.

Long time retired, but I still learn things here. TY

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