Emergency medicine-trained physicians are proficient in the insertion of transvenous pacemakers.
Study Objective: The insertion and management of a temporary transvenous pacemaker can be a lifesaving procedure in the emergency department setting. We compare the success and complication rates associated with temporary transvenous pacemaker insertion between physicians trained in either emergency...
| Publicado en: | Annals of Emergency Medicine Vol. 43; no. 4; pp. 469 - 475 |
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| Autores principales: | , , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Elsevier B.V.
2004 Apr
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106779061&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106779061 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01960644 1WN jtl: Annals of Emergency Medicine issn: 01960644 maglogo: N pubinfo: dt: 2004 Apr vid: 43 iid: 4 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 106779061 106779061 NLM15039689 2004158209 10.1016/j.annemergmed.2003.09.019 NLM15039689 106779061 ppf: 469 ppct: 6 formats: tig: atl: Emergency medicine-trained physicians are proficient in the insertion of transvenous pacemakers. aug: au: Birkhahn RH Gaeta TJ Tloczkowski J Mundy T Sharma M Bove J Briggs WM Birkhahn, Robert H Gaeta, Theodore J Tloczkowski, John Mundy, Todd Sharma, Manish Bove, Joseph Briggs, William M affil: Department of Emergency Medicine, New York Methodist Hospital, Brooklyn, NY 11215, USA sug: subj: Pacemaker, Artificial Emergency Medicine Cardiology Clinical Competence Pacemaker, Artificial Adverse Effects Record Review Retrospective Design Interrater Reliability kappa Statistic Confidence Intervals Adult Middle Age Aged Aged, 80 and Over Female Male Human Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Female Male ab: Study Objective: The insertion and management of a temporary transvenous pacemaker can be a lifesaving procedure in the emergency department setting. We compare the success and complication rates associated with temporary transvenous pacemaker insertion between physicians trained in either emergency medicine or cardiology.Methods: This was a retrospective medical record review of all patients with a billing code for temporary transvenous pacemaker insertion at our institution between July 1999 and December 2002. Patients were excluded if the temporary transvenous pacemaker was not supervised by an attending physician or was placed under fluoroscopy or if the indication for pacing was asystole. Cases were reviewed by 2 physicians certified in emergency medicine and categorized by the specialty training of the attending physician providing direct supervision.Results: During the review period, 10 emergency medicine faculty and 8 cardiologists directly supervised 141 of the 158 temporary transvenous pacemaker insertions in 154 patients. Twenty-four were placed for asystole, 4 were placed under fluoroscopy, and 13 were placed without direct attending supervision, leaving a total of 117 cases (30 emergency medicine, 87 cardiology) for review. The procedure was successful 97% (95% confidence interval [CI] 90% to 100%) of the time for emergency medicine faculty and 95% (95% CI 91% to 100%) of the time for cardiology faculty. Complications were seen in 23% (95% CI 7% to 39%) of the temporary transvenous pacemakers inserted by emergency medicine attending physicians and 20% (95% CI 11% to 28%) of the temporary transvenous pacemakers inserted by cardiologists. There was no statistical difference in errors between the specialties, and no complication resulted in death or prolonged disability.Conclusion: Physicians trained in emergency medicine perform temporary transvenous pacemaker insertions in the acute care setting with a proficiency similar to that of their counterparts in cardiology. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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