Pacemaker

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)
• Arm immobilizer

Have available:

• Standard 4x4’s for end of procedure
• (Milechman) Standard glide wire

Sutures:

Physician	Leads	Closure
Milechman	0 Silk ties 0 Silk	2-0 Vicryl 3-0 Vicryl 4-0 Vicryl
Romick	0-Ethibond on a CT-2 x3	2-0 PDS on a CT-1 3-0 Monocryl on a SH 4-0 Monocryl on a SH
Hao	0- Silk	2-0 Vicryl on a CT-1 ( may need multiple) 2-0 PDS 3-0 Monocryl on a SH 4-0 Monocryl on a SH 0 Ethibon for the can