Temporary transvenous pacing: endangered skill.
Emerg Med J. 2012 Nov;29(11):926-7
Authors: Sharma S, Sandler B, Cristopoulos C, Saraf S, Markides V, Gorog DA
BACKGROUND: Temporary cardiac pacing although is an essential requirement for core medical training (CMT) in UK, there are no defined training measures and guidelines available as to who should perform this.
METHODS: We conducted an anonymous survey of 300 non-cardiology medical registrars regarding their individual ability, experience and training received in temporary pacing wire (TPW) insertion.
RESULTS: A total of 202 (67%) responses were received. 61% (123) had not performed any TPW insertion before becoming a registrar. Only 18% (38) felt confident in inserting a TPW unsupervised and only 14 (7%) had ever received any formal training. The majority, 169 (84%), did not feel that their on-call consultant general physician would be able to perform the procedure.
CONCLUSION: This survey shows that general medical registrars lack a major life-saving skill that is required as part of CMT. Thus, there is now an urgent clinical governance need to either formally train physicians or abandon the concept and practice of general internal medicine-led temporary pacing, and devolve this to cardiologists.
PMID: 21896675 [PubMed - indexed for MEDLINE]