Pacemaker

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Revision as of 20:33, 21 February 2023 by Warneh (talk | contribs)

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.


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