>> Barnett: A RECENT FDA ARTICLE IN THE JOURNAL Nursing2010
DESCRIBES A VARIETY OF PROBLEMS ASSOCIATED WITH
TEMPORARY PACING LEADS.
TEMPORARY PACING IS USED DURING EMERGENCY TREATMENT OF
SOME BRADYARRHYTHMIAS AND TACHYARRHYTHMIAS.
IT'S ALSO USED PROPHYLACTICALLY FOR PATIENTS AT RISK FOR
BRADYARRHYTHMIAS DURING CARDIOVASCULAR SURGERY.
>> STAFF IN ONE HOSPITAL REPORTED MANY INADVERTENT
DISCONNECTIONS WITH A NEW, REUSABLE EXTENSION CABLE THAT
WAS SUPPOSED TO CONNECT THE LEAD TO THE PACEMAKER.
THIS PROBLEM HADN'T OCCURRED WITH THE OLD CABLE.
STAFF RESORTED TO USING SURGICAL TAPE TO MAINTAIN THE CONNECTION
BETWEEN THE PACING WIRE AND THE EXTENSION CABLE,
A PRACTICE THAT'S NOT RECOMMENDED IN THE INSTRUCTIONS.
>> LEADS CAN ALSO FRACTURE.
IN ONE CASE, THE DISTAL TIP OF A TEMPORARY EPICARDIAL LEAD
BROKE OFF AND REMAINED IN THE PATIENT WHEN THE LEAD WAS
REMOVED 13 DAYS AFTER SURGERY.
THE LEAD MANUFACTURER HAD RECOMMENDED ONLY A
7-DAY IMPLANT DURATION.
>> THERE'S ALSO A RISK OF MISCONNECTION WHEN USING A
BALLOON TEMPORARY PACING CATHETER THAT HAS AN EXTRA LUMEN
FOR INFUSION, HEMODYNAMIC MONITORING, OR BLOOD SAMPLING.
IN ONE CASE, A PATIENT'S CAREGIVER ACCIDENTALLY CONNECTED
I.V. TUBING TO THE PACING CATHETER'S BALLOON INFLATION
PORT, CAUSING THE BALLOON TO BURST INSIDE THE PATIENT.
>> THE ARTICLE RECOMMENDS SEVERAL WAYS TO HELP AVOID
PROBLEMS LIKE THESE.
THEY INCLUDE VERIFYING THAT PROPER CONNECTIONS HAVE BEEN
MADE THROUGHOUT THE ENTIRE PACING SYSTEM AND KNOWING YOUR
HOSPITAL'S POLICY AND PROCEDURES FOR HANDLING DEFECTIVE DEVICES.
YOU CAN FIND THE FULL ARTICLE ON OUR WEB SITE.
