How to do transcutaneous pacing
Other platforms explain it with text and video. In VMS you practice it on the patient.
Pacing treats unstable slow heart rates that do not respond to medicine.
Step by step
Indication
Symptomatic bradycardia not responding to atropine or when atropine is unlikely to work. [1]
Pads
Front and back, or front and side. [1]
Sedation
Pain relief and sedation if possible. [1]
Rate
Often 60 to 80 per minute. [1]
Capture
Increase current until each spike is followed by a wide QRS; set slightly above that. [1]
Pulse
Confirm a pulse with each beat (femoral, not carotid). [1]
Common errors
- Checking pulse at the carotid (muscle twitches).
- No sedation.
- Not confirming mechanical capture.
Practice it in VMS
In VMS you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
VMS cases that train this skill
Sources
Facts and steps follow NASEMSO National Model EMS Clinical Guidelines; NREMT psychomotor skill sheets (EMT and Paramedic). VMS is not affiliated with these organizations. Updated: 2026-10-11.