When is transcutaneous pacing considered in PALS?

When is transcutaneous pacing considered in PALS?

• A. For unstable symptomatic bradycardia not responsive to atropine or when pacing is needed
• B. For stable tachycardia
• C. For pulseless electrical activity only
• D. Only after defibrillation

Answer: (A)

Transcutaneous pacing is a temporary, noninvasive way to support heart rate in children with unstable symptomatic bradycardia. It is considered when the bradycardia is causing poor perfusion and atropine has not resolved it, or when pacing is needed because of a high‑grade AV block or other conduction problem. It is not indicated for stable tachycardia, and it isn’t the default approach for pulseless rhythms or something done only after defibrillation. In practice, external pads are placed and the pacer set to deliver pacing that restores a perfusing rate while addressing the underlying cause and arranging longer-term pacing if needed.

Transcutaneous pacing is a temporary, noninvasive way to support heart rate in children with unstable symptomatic bradycardia. It is considered when the bradycardia is causing poor perfusion and atropine has not resolved it, or when pacing is needed because of a high‑grade AV block or other conduction problem. It is not indicated for stable tachycardia, and it isn’t the default approach for pulseless rhythms or something done only after defibrillation. In practice, external pads are placed and the pacer set to deliver pacing that restores a perfusing rate while addressing the underlying cause and arranging longer-term pacing if needed.