Pacing for EMS - Transcutaneous Pacing Failure to Capture?

One of the skills that EMS performs in the field is somewhat rare and requires that paramedics be well trained and able to recognize problems. Transcutaneous Pacing (TCP) is performed by placing defibrillation pads on the patient and administering shocks in order to get the heart beating faster and more effectively. This procedure requires that the paramedic recognize when the pacing is successful, i.e., electrical and mechanical "capture" is achieved. But do paramedics easily recognize failure to capture? Not so much. Here are two case studies of real patients on real 911 calls in which the paramedics attempted TCP, but failed to capture, and failed to recognize that they were not actually pacing the patient. Learn from the case studies, and the tips contained at the end of the presentation. 0:00-1:43 Introduction 1:44- 8:55 Case Study #1 A Hot Mess 8:56-10:02 What Does Capture Look Like? 10:03-15:01 They Just Keep Going 15:02- 20:04 Case Study #2 Another Attempt 20:05-22:14 Tips for Successful Pacing