Please enable JavaScript.

Coggle requires JavaScript to display documents.

Pacemakers (Preop history (Establish whether pt has PPM/ICD, why inserted,…

- - - - Symptoms of IHD or exacerbation of unstable angina, anaemia
      - Arrhythmia symptoms syncope, falls, dizzyness
      - Presence of significant comorbidities: Revised Cardiac Risk Index
      - Renal impairment
    - - Signs of CCF (auscultation: poor peripheral perfusion, creps/cardiac wheeze, peripheral oedema, weight gain, hepatomegaly)
- - - - Ensure cautery tool and current return pad are positioned so the current pathway does not pass through or near the PPM and leads
      - Avoid proximity of cautery's electrical field to the pulse generator or leads
      - Use short, intermittent, irregular bursts at the lowest feasible energy levels
      - Use bipolar or harmonic scalpel if possible
    - - Beam should not be focussed near the pulse generator
      - If lithotripsy triggers on R wave, atrial pacing may need to be disabled before the procedure
    - - Generally contraindicated
      - If absolutely necessary, consult a cardiologist
    - - May be administered without significant damage to a disabled PPM
      - Must undergo comprehensive interrogation first
      - ICD functions should be disabled, but be prepared to treat ventricular arrhythmias that occur secondary to ECT
      - PPM dependent patients may require a temp pacing system