Third-degree burns associated with transcutaneous pacing

Abstract

A 69-year-old severely obese diabetic woman developed nausea, vomiting and diarrhoea which caused multiple metabolic alterations leading to hypotension and bradycardia due to slow atrioventricular junctional rhythm. Transcutaneous pacing (TCP) was initiated and maintained until the underlying heart rate and blood pressure normalised. TCP gel pads were kept in place prophylactically after pacing was terminated. Gel pads remained attached to the anterior thorax and back for a total of 36 hours. During this time the patient developed third-degree burns at the side of gel pad attachment. With appropriate wound care and after a long hospitalisation, the patient was discharged in stable condition. This case demonstrates that prolonged use of TCP gel pads without frequent replacement may lead to third-degree burns. It also suggest that prophylactic use of TCP gel pads should be avoided.

Iatrogenic Spark Burn Injury to the Chest From a Transcutaneous Pacing Patch

“…They suggested that transcutaneous pacing should be performed for a short duration, if possible. So, physicians should not place the gel pads prophylactically [9]. Singleton et al reported a case of third degree burn injury due to transcutaneous pacing in a patient with third-degree heart block.…”

Third-degree burns caused by transcutaneous pacing for third-degree heart block

“…Another case of pacing-induced burns was believed to be explained by severe obesity (body mass index of 58). 10 Malfunction of the external pulse generator can lead to skin burns via electrolysis if a leakage current is continuously applied at the skin electrode patch during cardiac surgery. 11 Inadequate electrolytic gel at the electrode–tissue interface was likely contributory in a case of pacing-induced burns in which the transcutaneous pacing pads were reused in a Malaysian hospital.…”

Desenvolvimento De Tecnologia Educacional Para Manejo Do Marca-Passo Transcutâneo Em Idosos No Atendimento Pré-Hospitalar Móvel

“…Contudo, os autores ressaltam que os fabricantes sugerem que as almofadas devem ser substituídas diariamente. Portanto, evidencia-se que o MPTC pode estar associado às queimaduras graves e deve ser utilizado com duração mais curta possível, cabendo ao enfermeiro avaliar a integridade da pele do paciente [21][22] .…”