magnets and EMS

[tniuqs]

Squint,

If I was getting zapped repeatedly I would not give a crap if you told me I had to ride roof rack because there was a magnet up there. Then again that's just me.....some people are SO picky.

CC:

At - 28 C this morning I think you may want to rethink that .... but funny thing how errors can be made when wearing steel toed boots, getting in and out of the passenger doors ... oops. :shock:

So while we are on the topic there is dang so many new pacers on the market these days, most of the patients either knew or had a little card in their wallets identifying just what type ... I could not remember all the flavours off the top of my balding head .....

So a little google search located this gem.

1st Letter Chamber

Paced

2nd Letter Chamber

Sensed

3rd Letter Response to

Sensed Beat

4th Letter Programmability

5th Letter

Antitachycardia Function

A A T P P (pacing)

V V I M S (shock)

D D D C D (dual: pacing + shock)

O O O R

O

A = Atrium

V = Ventricle

D = Dual (both chambers)

O = None

T = Triggered

I = Inhibited

D = Double (Atrial triggered and ventricular inhibited)

P = Simple programmability

M = Multiprogrammable

C = Communicating (telemetry)

R = Rate adaptive

The first 3 letters are used most commonly. More modern pacemakers have multiple functions. A pacemaker in VVI mode denotes that it paces and senses the ventricle and is inhibited by a sensed ventricular event. Alternatively, AAT mode represents pacing and sensing in the atrium, and each sensed event triggers the generator to fire within the P wave.

The DDD mode denotes that both chambers are capable of being sensed and paced. This requires two functioning leads, one in the atrium and the other in the ventricle. In the ECG, each QRS is preceded by two spikes. One indicating the atrial depolarization and the other indicating the initiation of the QRS complex. Given that one of the leads is in the right ventricle, a left bundle-branch pattern may also be evident upon the ECG. Note that a two-wired system need not necessarily be in DDD mode, since the atrial or ventricular leads can be programmed off. Additionally, single tripolar lead systems are available that can sense atrial impulses and either sense or pace the ventricle. Thus, this system provides for atrial tracking without the capability for atrial pacing and can be used in patients with atrioventricular block and normal sinus node function.

Pacemaker programming can be performed noninvasively by an electrophysiologist or cardiologist. Because of the myriad of pacemaker types, patients should carry a card with them providing information about their particular model. This information is crucial when communicating with the cardiologist about a pacer problem. Most pacemaker generators, however, have an x-ray code that can be seen on a standard chest x-ray. The markings, along with the shape of the generator, may assist with deciphering the manufacturer of the generator and pacemaker battery. This may be helpful in the event a patient neither recalls the company nor has the permanent pacemaker card.

Magnet Inhibition

Placing a magnet over a permanent pacemaker causes sensing to be inhibited by closing an internal reed switch. This only temporarily "reprograms" the pacer into the asynchronous mode, where pacing is initiated at a set rate. It does not turn the pacemaker off. Each pacemaker type has a unique asynchronous rate for beginning-of-life (BOL), elective replacement indicator (ERI), and end-of-life (EOL). Therefore, application of a magnet can determine if the pacer's battery needs to be replaced. Further interrogation, or manipulating of the device, should be performed by an individual skilled in the technique. Patients should carry a card that contains information about their particular pacemaker, since these rates are dependent on the manufacturer and the model.

cheers

[Richard B the EMT]

Time to stop and explain to me, again: What is/are a "Pedimate"? I don't recall ever hearing that one before. Something new, or I might know under a different name?

[Arkymedic]

Richard, most often when one says pedi-mate it is usually one of these http://www.quadmed.com/product.php?productid=611. You guys might call it something different though. This is a good example of how to use one if you never have had the chance http://www.youtube.com/watch?v=BUI2vxORaT8.

Time to stop and explain to me, again: What is/are a "Pedimate"? I don't recall ever hearing that one before. Something new, or I might know under a different name?

[Dustdevil]

This is a good example of how to use one if you never have had the chance

.'>

.

[JakeEMTP]

FAIL!

:sign5:

[brentoli]

Squint,

If I was getting zapped repeatedly I would not give a crap if you told me I had to ride roof rack because there was a magnet up there. Then again that's just me.....some people are SO picky.

You and your damn zapper.

[Arkymedic]

Thanks Dust I appreciate you fixing it for me. I hit ctrl and v to paste at the time I was typing the period after chance and it went to the end of the link.

FAIL! Never put a period on the end of a web link. :wink:

[Richard B the EMT]

Thanks, Arkymedic

[crazycanuck]

You and your damn zapper.

At least I Can't Die....so I guess if you don't have one you're a suckaaaaaa!

[Eydawn]

On a similar note (and perhaps belonging in its own thread) does anyone have experience with Vagal Nerve Stimulators in refractory seizure patients and the proper use of VNS magnets?

Wendy

CO EMT-B