CanadiEM - January 07, 2020 - By Costello L
"Key take away points:
- Never attempt to drain a pocket hematoma in the ED!
- Most pocket and systemic infections require intravenous antibiotics and removal of the pacemaker.
- Phlebitis and thrombophlebitis are common but usually do not pose a problem due to collateralisation of veins. However, consider DVT in your differential for arm swelling or pain.
- Think of pacemaker syndrome whenever someone comes in with vague symptoms or CHF –especially if the pacemaker is new or has been recently adjusted.
- An ECG and CXR are always good starting investigations for pacemaker malfunction but findings may be subtle. If you suspect a malfunction, then patients should ultimately undergo a pacemaker interrogation."