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Reminder of important clinical lesson
CASE REPORT
Third-degree burns associated with transcutaneous pacing
  1. Joshua E Payne1,
  2. Jacob L Morgan2,
  3. Richard R Weachter1,
  4. Martin A Alpert1
  1. 1Cardiovascular Medicine, University of Missouri, Columbia, Missouri, USA
  2. 2Internal Medicine, University of Missouri, Columbia, Missouri, USA
  1. Correspondence to Professor Martin A Alpert, alpertm{at}health.missouri.edu

Summary

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.

  • cardiovascular medicine
  • arrhythmias
  • pacing and electrophysiology

https://doi.org/10.1136/bcr-2018-226769

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    Footnotes

    • Contributors All listed authors contributed to this manuscript. JEP and JLM conducted the initial chart review and case report as well as a comprehensive review and summary of relevant literature. MAA and Weachter contributed to editing and formatting of the manuscript as well as additional search, interpretation and summary of the literature regarding this topic.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.