Florida State Paramedic Practice Exam

How should a third-degree heart block be treated?

1. Medications only

2. Defibrillation

3. Transcutaneous pacing (TCP)

4. Cardiac exercise

The correct answer is: Transcutaneous pacing (TCP)

In the case of a third-degree heart block, also known as complete heart block, the treatment of choice is transcutaneous pacing (TCP). This condition is characterized by a complete interruption of electrical signals between the atria and ventricles, which can lead to bradycardia and potential hemodynamic instability. Transcutaneous pacing provides immediate temporary pacing to stimulate the heart and restore an adequate heart rate and rhythm, thereby improving perfusion to vital organs. TCP is especially important in emergency situations where patients may present with signs of poor cardiac output, such as altered mental status or hypotension. It effectively regulates the heart's rhythm until more permanent solutions, such as a pacemaker insertion, can be arranged. Medications may not adequately address the immediate needs of a patient with third-degree heart block and are typically used for other cardiac conditions. Defibrillation is inappropriate in this case since it is indicated for life-threatening arrhythmias like ventricular fibrillation, not for a condition where there's a need for pacing. Cardiac exercise is not a treatment for third-degree heart block, as it could potentially exacerbate symptoms and lead to further complications. Hence, transcutaneous pacing is the most suitable intervention for rapid stabilization in this scenario.