In this presentation, the evidence base for transcutaneous pacing (TCP) will be described, interactive ECG interpretation polls will be used to teach the audience how to recognize true electrical capture, and clear steps to improve TCP care in different prehospital systems will be offered. Transcutaneous pacing is a procedure reserved for some of the sickest EMS patients, so learning how to provide higher quality TCP could make a serious impact on the quality of care in prehospital systems. The presentation will begin by describing the existing literature on TCP, from the first set of cases published by Paul Zoll to the most recent data from observational prehospital literature and the electrophysiology lab. Next, results will be shared from the largest multicenter observational study of transcutaneous pacing electrocardiogram files to date that demonstrate the rarity of true electrical capture. Next, an engaging session quizzing audience members on interpretation of TCP cases that can be particularly challenging, using real cases from our prehospital transcutaneous pacing monitor file database, will improve participants’ ability to distinguish pacer artifact from electrical capture. Finally, solutions for leaders in EMS organizations to improve TCP in their system will be described, including new protocols with a focus on identifying the correct patients, training paramedics on this difficult skill, using high currents, and deploying multiple confirmation methods.

NYS CME: All Levels - Core - Cardiac