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tolerability.",{"id":215,"name":216},1,"Course previews",[218,229,234,239,246],{"type":219,"data":220},"video",{"readDurationInSeconds":221,"video":222},115,{"platform":223,"name":224,"url":225,"size":226},"YouTube","Transcutaneous pacing: identifying the tools","https:\u002F\u002Fwww.youtube.com\u002Fwatch?v=UInoEPPjwKo",{"width":227,"height":228},200,113,{"type":230,"data":231},"free_text",{"readDurationInSeconds":232,"text":233},9.6,"\u003Cp>Most defibrillator machines can be converted into transcutaneous pacers, if required. 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With our \u003Cstrong>\u003Ca href=\"https:\u002F\u002Fwww.medmastery.com\u002Fcourse\u002Femergency-procedures-masterclass\">Emergency Procedures Masterclass (Part 1)\u003C\u002Fa>\u003C\u002Fstrong> course, you'll get the lowdown on the tools involved in each treatment or diagnostic procedure, understand when and how to perform them, and discover how to anticipate and minimize complications. \u003C\u002Fp>",{"type":240,"data":241},"cta",{"readDurationInSeconds":242,"text":243,"buttonText":244,"buttonUrl":245},3.466666666666667,"Become a great clinician with our video courses and workshops","Start learning for free","https:\u002F\u002Fwww.medmastery.com\u002Fuser\u002Fregister",{"type":230,"data":247},{"readDurationInSeconds":248,"title":249,"text":250},52,"Video Transcript","\u003Ch3 dir=\"ltr\" id=\"docs-internal-guid-85f06ca0-7fff-d6cc-b9ea-8439cc4769e1\">\u003Cspan>Transcutaneous pacing\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp dir=\"ltr\">\u003Cspan>[00:00]\u003C\u002Fspan>\u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cspan>Most defibrillator machines can be converted to a transcutaneous pacer by turning on the pacer feature. Pacer pads are placed in the same way as the defibrillator, but because the pads cannot both sense and pace at the same time, you have to connect the monitor leads to the machine.\u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 dir=\"ltr\">\u003Cspan>Transcutaneous pacing settings\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp dir=\"ltr\">\u003Cspan>[00:25]\u003C\u002Fspan>\u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cspan>Once the pace feature is turned on, there are only two settings you need to control. The rate button sets the heart rate you want, and the output is the amount of energy, measured in milliamps, required to conduct electricity through the patient's chest wall and heart. The bigger the patient, the more output required. You should generally aim for 1 mA \u002F kg, so an average-sized adult, who might weigh 70 kg, will require approximately 70 mA. But kids and small adults may require less energy.\u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 dir=\"ltr\">\u003Cspan>Discomfort and sedation during transcutaneous pacing\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp dir=\"ltr\">\u003Cspan>[01:00]\u003C\u002Fspan>\u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cspan>The constant electrical shocks will depolarize all muscle cells between the two pads and will cause involuntary contraction of the chest wall muscles. This is really uncomfortable for the patient and may even cause them not to be able to tolerate the procedure. Pain medications and sedatives such as fentanyl and midazolam can help decrease the discomfort until the painless transvenous pacer is placed.\u003C\u002Fspan>\u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cspan>Now that you are familiar with the tools, let's learn how to perform transcutaneous pacing.\u003C\u002Fspan>\u003C\u002Fp>",{"courses":252,"showAwardsBelow":48},[253],{"id":254,"isFreeCmeCourse":255,"title":256,"type":257,"specialization":258,"teachers":260,"cmeCredits":262,"teacherIllustration":263,"backgroundImage":264,"relativeUrl":265,"lastChanged":266,"created":267,"description":268,"relativeURL":265,"meta":269},5364,false,"Emergency Procedures Masterclass (Part 1)","course",[259],"Emergency medicine and critical care",[261],"Siamak Moayedi, MD",4,"https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F99f55f1f-61b4-4ac9-8b50-644a30cb3886","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F99f55f20-4e4d-4ec0-84db-e1d65ce22669","\u002Fcourses\u002Femergency-procedures-masterclass-part-1","1768935864","1535559802","Don’t let emergency medicine stump you. Learn how to perform some of the most essential procedures in emergency medicine—from lumbar punctures and vertigo maneuvers to transvenous pacing and defibrillation—so you can diagnose and treat important conditions with confidence. 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Learn when injectable cholesterol medication helps and how PCSK9 inhibitors work.",{"alt":342,"title":291,"size":343,"location":344},"Two PCSK9 inhibitor autoinjector pens—an injectable cholesterol medication—shown on a light blue background.",{"width":321,"height":321},{"bucket":296,"key":345},"\u002F2026-05\u002FC121(3)_magazine image.png",{"id":347,"title":348,"relativeURL":349,"image":350,"professionLong":351,"profession":352,"weight":262},1563,"Franz Wiesbauer, MD MPH","\u002Fteachers\u002Ffranz-wiesbauer-md-mph","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F9c43cef0-41ee-4005-9e4a-d8711c816401","Franz is the founder and CEO of Medmastery. 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