Emergency bedside rapid cardiac pacing challenges
Professor Liu Kunshen of cardiac center, the fifth hospital of Hebei Medical University adopting the "emergency bedside rapid cardiac pacing" without the need of x-ray guidance, and only requiring needle puncture through the subclavicular vein, was successful in cardiac pacing. The whole course of the procedure was shortened to 2-4 minutes in contrast to the past technique of cardiac pacing requiring 20-30 minutes; more than 200 critically ill patients were rescued with this method.
Professor Liu Kunshen, after years of elaborating investigation, innovated the technique "Emergent bedside rapid cardiac pacing" which avoided the shortcomings of insufficient cardiac pacing of the former conventional procedure. Following the clinical trial in more than 200 cases it was proved that this new type instant cardiac pacing did not need x-ray guidance and could be completed at bedside. The electrode was inserted through the right supra-clavicle route, nearly approaching the permanent pacemaker inserting route of the present time. An electrode was then left at the stable position, not easily to get loose, less likely to be infected, and easily to be kept clean so that the electrode could be detained for as long as 31 days. This technique can be used extensively for urgent rescue and supporting cardiac rhythm and life in seri9ous bradycardia and cardiac arrest due to acute myocardial infarction, severe myocarditis, disturbance of electrolytes, drug poisoning, anesthesia, surgical procedures, electric shock, struck by lighting, renal failure etc.
As recommended by Professor Liu Kunshen the technical key point of this emergency bedside cardiac pacing was the "J type introduction sheath" which rapidly introduced the electrode catheter into the apex of the right ventricle for pacing. The detailed steps of manipulation was to select the point of puncture at the fossa between the boundary of sternum and the clavicle head of the sternomastoid muscle, where there was a clear and fixed anatomical landmark. Then the puncture needle was inserted into the subclavicular vein with a fixed direction of 45o along the sagittal section and 15o with the coronal section into the ventral direction. The technique can be easily handled by the doctors at the grass root level. The needle could be inserted to the depth of 1/10 of body length plus 10-15 cm (approximately 28-33 cm); generally the cardiac pacing could be started at the apex of the right ventricle., 百拇医药
Professor Liu Kunshen, after years of elaborating investigation, innovated the technique "Emergent bedside rapid cardiac pacing" which avoided the shortcomings of insufficient cardiac pacing of the former conventional procedure. Following the clinical trial in more than 200 cases it was proved that this new type instant cardiac pacing did not need x-ray guidance and could be completed at bedside. The electrode was inserted through the right supra-clavicle route, nearly approaching the permanent pacemaker inserting route of the present time. An electrode was then left at the stable position, not easily to get loose, less likely to be infected, and easily to be kept clean so that the electrode could be detained for as long as 31 days. This technique can be used extensively for urgent rescue and supporting cardiac rhythm and life in seri9ous bradycardia and cardiac arrest due to acute myocardial infarction, severe myocarditis, disturbance of electrolytes, drug poisoning, anesthesia, surgical procedures, electric shock, struck by lighting, renal failure etc.
As recommended by Professor Liu Kunshen the technical key point of this emergency bedside cardiac pacing was the "J type introduction sheath" which rapidly introduced the electrode catheter into the apex of the right ventricle for pacing. The detailed steps of manipulation was to select the point of puncture at the fossa between the boundary of sternum and the clavicle head of the sternomastoid muscle, where there was a clear and fixed anatomical landmark. Then the puncture needle was inserted into the subclavicular vein with a fixed direction of 45o along the sagittal section and 15o with the coronal section into the ventral direction. The technique can be easily handled by the doctors at the grass root level. The needle could be inserted to the depth of 1/10 of body length plus 10-15 cm (approximately 28-33 cm); generally the cardiac pacing could be started at the apex of the right ventricle., 百拇医药