How do you assess and manage potential complications related to patients with implanted pacemakers?

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Sample interview questions: How do you assess and manage potential complications related to patients with implanted pacemakers?

Sample answer:

How do you assess and manage potential complications related to patients with implanted pacemakers?

Assessment

  • Device interrogation: Wireless or transvenous interrogation of the pacemaker to assess its function, battery status, lead integrity, and programmed settings.
  • Physical examination: Assessment for signs of infection (erythema, swelling, drainage), lead movement, lead wire breakage, and device malfunction (e.g., irregular heart rate, episodes of syncope).
  • Electrocardiogram (ECG): Monitoring to assess pacemaker function and detect any arrhythmias or conduction abnormalities.
  • Pulse oximetry: Monitoring to assess proper pacemaker function and prevent bradycardia-related complications.

Management

General Management

  • Infection prevention: Meticulous wound care, antibiotic prophylaxis during invasive procedures, and strict adherence to aseptic technique.
  • Lead management: Fluoroscopy or echocardiography to ensure lead placement and prevent lead dislodgement or breakage.
  • Device optimization: Programming the pacemaker according to the patient’s clinical needs and electrophysiological data.
  • Regular follow-up: Schedule follow-up visits to monitor device function, battery status, and overall patient well-being.

Specific Complications and Management

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