Question

You have begun transcutaneous pacing of a 52-year-old male who is in third-degree heart block. He was initially unresponsive to all stimuli, with a pulse of 32, blood pressure 60 by palpation, and a respiratory rate of 12. Which of the following is least helpful when determining the effectiveness of transcutaneous pacing?

A) Evidence of mechanical capture

B) Increased level of consciousness

C) Evidence of electrical capture

D) Increased blood pressure

Answer 1

In transcutaneous pacing, determining the effectiveness can be done by observing evidence of electrical and mechanical capture, as well as assessing changes in blood pressure. However, the level of consciousness may not always correspond to the success of transcutaneous pacing.

Step-by-step explanation:

In third-degree heart block, there is no correlation between atrial activity (the P wave) and ventricular activity (the QRS complex). In this case, the AV node assumes the role of pacemaker and continues initiating contractions at a rate of approximately 40-60 contractions per minute, which is adequate to maintain consciousness.

Therefore, in transcutaneous pacing, the least helpful when determining effectiveness would be increased level of consciousness. This is because even with correct electrical capture, the patient's level of consciousness can vary depending on other factors.