Problems with temporary cardiac pacing

BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7312.527 (Published 08 September 2001) Cite this as: BMJ 2001;323:527

Expecting trainees in medicine to perform transvenous pacing is no longer acceptable

  1. J J Murphy, consultant physician and cardiologist
  1. Department of Medicine, Darlington Memorial Hospital, Darlington, Co Durham DL3 6HX

    Temporary transvenous cardiac pacing is a potentially life saving intervention used primarily to correct profound bradycardia. In Britain temporary pacing is usually provided in district general hospitals by general physicians as part of an emergency service. In practice, pacing wires are inserted by doctors in training, with little teaching or supervision, and complication rates are high. Can such a service be allowed to continue?

    Differences in the provision of health care make international comparisons difficult. In North America and Western Europe temporary pacing is generally the province of specialist cardiac units. In Britain the procedure remains a part of training in general medicine. Pacing is usually learnt at a junior level and taught at the bedside by fellow doctors in training. On average, a doctor will see two temporary pacings and do two under supervision before being left unsupervised.1 In the only prospective study in district hospitals consultants were involved in just …

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