Attempted transcutaneous pacing using zoll one step cpr complete pads with r series after atropine was unsuccessful in the field for symptomatic bradycardia - hr 20's, low bp gcs3, r series on pacer mode, rate set at 70 bpm, mas attempted between 40 and 80 mas with no visible electronic capture, no change in natural monitored heart rate or palpated pulse rate, and no physical signs of capture.Troubleshooting: changed pads, condition deteriorated, cpr performed, transvenous pacemaker inserted and successfully paced the pt.Transferred to another facility.No lot number to report on the one step pads.Witnessed cardiac arrest pta - initial rhythm bradycardia.O2, lvf, atropine, paced pta, preceding 'sx' cp, sob, dizzy, decompensated during long transport.Atropine and maximum output pacing unsuccessful.Cpr initiated immediately pta.Pea on arrival to ed, intubated.Attempted to maintain heart rate and blood pressure with dopamine without benefit.Levo and epi drips initiated.Transcutaneous pacing completely ineffective.Transvenous pacemaker stabilized pt for tx to genesis.
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