When consulting with a Base Hospital Physician for Transcutaneous Pacing (TCP) authorization, we recommend a proactive approach and anticipating the need for sedation and analgesia. We recommend that you discuss not only the authorization for TCP, but a plan tailored to your patient presentation and needs during that initial consult.
If procedural sedation and analgesia were not discussed during the consult for TCP, TCP has been started and the patient is now normotensive, it is acceptable to administer midazolam as per your Medical Directive. Monitor your patient and determine the need for a change in your pharmacological approach. Often, your patient will respond positively to procedural sedation alone.
If the patient is hypotensive, or based on the clinical presentation, you would like to advocate for co-administration of sedation (midazolam) and analgesia (opioids), we recommend to consult with a Base Hospital Physician to establish a pharmacological approach that is safe and tailored to your patient’s needs.