Pacemaker
From Bay Area Structural Heart Wiki
Pacemaker notes for the Cath Lab
Hao Notes:
- No ioban until after he gets access (cut in 1/2)
- Micropuncute access with ultrasound. Slip tip. Single stick for dual lumen. Mosquitos to hold wires.
- Place ioban, lido, make pocket. Needs weilander, richardson and short debakey withouth teeth on patient chest.
- After pocket made needs 11 blade to cut wires free.
- If using a Tyrex do not invert it, hand it to him with scissors
Medications
- Cefazolin (Kefzol, Ancef) 1gm / 2gm (weight based) 1G Vanco if PCN allergy
- 15ml Betadine 10% into 500ml 0.9% NS pocket wash
- Lidocaine / Bupivucaine (50/50)
- 1000ml Heparinized saline (500ml/500ml split on table between Bacitracin and Flush tubs)
- Fentanyl / Versed for sedation (optional?)
- NS to L-sided IV (for venogram)
Supplies
Open:
- Pacemaker pack
- Pacemaker instruments
- Micropuncture
- Smoke evac bovie pen
- X-ray detectable 4x4’s x2
- Ioban
- Blue towels (1 pack for drape)
- Suture (See Dr. list below)
- Fast-cath peelable sheaths (Ask rep for size)
- Irrisept irrigation bottle - Back hall Pixys under keyboard bottom shelf
Have available:
- Arm immobilizer
- Glue
- Standard 4x4’s for end of procedure
- (Milechman) Standard glide wire
Sutures:
| Physician | Leads | Closure |
|---|---|---|
| Milechman |
|
|
| Romick |
|
|
| Hao | 0- Silk |
|
