Transcutaneous Pacing in Cardiac Asystylae

The RC UK state that in the setting of cardiac arrest, the presence of P-waves makes obtaining an output more likely. But pacing is rarely successful in asystylae in the absence of P- waves and should not be attempted routinely in this situation. So what can we do pre-hospitality if pacing doesn't lie within our scope of practice? And I don't really see any reason why you shouldn't try it. It does seem a brutal thing to do but there's some evidence behind it,. James has said, as high risk that you're actually going to cause some pain and discomfort for the patient.