ventricular assist device-vad/lifevest

VAD

Care/Treatment: 

- Family and caregivers can answer most questions.

- Family may have the patient's home hospital on the phone to use as a resource (if so, stay in Scope of Practice and have home hospital, contact Base Hospital if necessary).

 

CPR: 

- ONLY if unresponsive, apneic, pulseless and a “red heart” alarm in (turbine non-pulsatile) VAD (ask family). Most types of VAD’s do not allow for CPR.

- 02, IV as indicated.

- Vitals: note that some patients may not have a palpable pulse or BP (are awake and talking).

- Paramedics may operate hand pump.

- Take all related VAD equipment to hospital with patient. 

- Cardiac Monitor, 12 Lead, Defibrillation and AED are all indicated per normal protocols.

 

Medications:

- No ALS drugs are contraindicated (unless family states otherwise).

- Patient may be on “blood thinners”.  Do not administer ASA with CP.

- No IO for LVAD patients.

 

Special Notes:

- Pulmonary Edema with hypotension and “red heart” alarm in 1st generation (displacement pulsatile): hand pump is indicated.

- Fluid challenge with caution (Contact Base).

- Pump failure can present as Cardiogenic Shock: hypotension, syncope, LOC or ALOC, Pulmonary Edema.

- Patient can still experience dysrhythmias—treat per protocols with BHC. 

- May also have an AICD implanted.

- Chest compressions and chest trauma can disrupt internal mechanics/connections of the VAD.

- VAD’s are 1st generation (pulsatile displacement pump) or 2nd generation (non-pulsatile turbine).

 

LifeVest

LifeVest (Automatic External Defibrillator): 

- Initiate CPR unless the vest device is broadcasting “press the response button,” “electric shock possible, do not touch patient,” or “bystander do not interfere.”

- If needed, remove the LifeVest and monitor / treat the patient with the standard monitor / defibrillator.

- To remove the LifeVest pull out or disconnect the battery, then remove the vest.

- Take the vest, modem, charger, and extra battery to the hospital

Call

M: 949-769-1162

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